Recubrimiento radicular de recesiones gingivales con matriz dérmica acelular / Root coverage of gingival recession with acellular dermal matrix

La recesión gingival es considerada como una deformidad o condición mucogingival, la Academia Americana de Periodontología, define a la recesión gingival como el desplazamiento del margen del tejido blando apical a la unión cemento-esmalte con la exposición de la superficie radicular. El tratamiento de las recesiones gingivales es un motivo de consulta común debido a razones estéticas, hipersensibilidad dentinaria, molestias durante el cepillado e incluso temor a la pérdida dentaria. Es una situación clínica común, 60% de la población humana tiene algún tipo de recesión gingival. Al realizar el examen clínico a paciente masculino de 55 años, se observó una recesión gingival tipo 1 (RT1) sin pérdida de inserción interproximal de la clasificación de Cairo. Se realizó el colgajo posicionado coronalmente (CPC) utilizando una matriz dérmica acelular (MDA) de origen humano OrACELL®. Se obtuvo resultado favorable en el recubrimiento de recesiones gingivales múltiples; considerándolos como una buena alternativa frente a los injertos gingivales autógenos. Concluyendo que, el uso de la matriz dérmica acelular para el tratamiento de la recesión gingival tipo 1 es una adecuada opción para el recubrimiento radicular. Se recomiendan más estudios a largo plazo para ver la estabilidad de los resultados obtenidos con la MDA (AU)

Gingival recession, considered a deformity or mucogingival condition, the American Academy of Periodontology, defines gingival recession as the exposure of the root surface resulting from migration of the gingival margin apical to the cementoenamel junction (CEJ). The treatment of gingival recessions is a common reason for consultation due to aesthetic reasons, dentin hypersensitivity, discomfort during brushing and even fear of tooth loss. It is a common clinical situation, 60% of the human population has some kind of gingival recession. Clinical examination of a 55-year-old male patient showed a type 1 gingival recession (RT1) without loss of interproximal insertion of the Cairo classification. Coronally advanced flap (CAF) was performed using an acellular dermal matrix (ADM) of human origin OrACELL®. Favorable results were obtained in the coating of multiple gingival recessions; considering them as a good alternative to autogenous gingival grafts. Concluding that, the use of the acellular dermal matrix for the treatment of gingival recession type 1, is a suitable option for root lining. Further long-term studies are recommended to see the elasticity of MDA outcomes (AU)

Prevalencia e indicadores de riesgo de recesiones gingivales en adolescentes de Valdivia en el año 2018 / Prevalence and risk indicators of gingival recessions in school senior students in the city of Valdivia in 2018

OBJETIVO: Determinar la prevalencia de recesiones gingivales e identificar indicadores de riesgo, en estudiantes de cuarto medio de la ciudad de Valdivia en el año 2018. MATERIAL Y MÉTODOS: Estudio de corte transversal. Se midió la prevalencia, distribución y tipo de recesión gingival según clasificación de Miller en estudiantes de cuarto medio de establecimientos públicos y subvencionados de la ciudad de Valdivia, seleccionados mediante muestreo aleatorio estratificado. Dos examinadores calibrados realizaron un examen clínico utilizando una sonda periodontal carolina del norte y un cuestionario escrito individual a cada estudiante para evaluar indicadores de riesgo. Los datos fueron tabulados y el análisis estadístico se realizó usando el programa estadístico SPSS 18 (IBM® SPSS® software). RESULTADOS: Se examinaron 310 estudiantes. La prevalencia encontrada fue de 68,4%. La Clase I de Miller se presentó en un 97,7%. La arcada mandibular con un 64,8% presentó mayor prevalencia de recesiones gingivales y los premolares inferiores fueron los dientes más afectados con un 47,7%. CONCLUSIÓN: Existe una alta prevalencia de recesiones gingivales en la población estudiada. Los estudiantes de establecimientos públicos presentan significativamente mayor prevalencia de recesiones gingivales y menor frecuencia de cepillado.

AIM: To determine the prevalence of gingival recessions and identify risk indicators in school senior students in the city of Valdivia in 2018. MATERIAL AND METHODS: Descriptive observational study. Prevalence, distribution and type of gingival recession were measured according to Miller classification in school senior students of public and charter establishments in the city of Valdivia, selected by stratified random sampling. A clinical examination was performed by two calibrated examiners using a North Carolina periodontal probe and an individual written questionnaire for each student to assess risk indicators. A descriptive analysis was performed using the statistical program SPSS 18 (IMB® SPSS® software). RESULTS: 310 students were examined. The prevalence found of at least one gingival recession was 68.4%. Miller's Class I was present in 97.7%. The jaw presented a higher prevalence of gingival recessions with 64.8% and the lower premolars were the most affected teeth with 47.7%. CONCLUSION: There is a high prevalence of gingival recessions in the population studied. Students in public establishments have a higher prevalence of recessions and a lower frequency of tooth brushing.

Recesión gingival y su efecto en la hipersensibilidad dentinaria / Gingival recession and its effect on dentin hypersensitivity

La exposición de dentina radicular asociada a una recesión gingival puede producir dolor ante distintos estímulos, situación que puede difi cultar la vida cotidiana de los pacientes que lo padecen, además de presentar complicaciones estéticas que pueden afectar la autoestima. La hipersensibilidad dentinaria tiene una etiología asociada a múltiples factores, siendo el principal factor de riesgo la recesión gingival, situación clínica común que se observa en gran parte de la población. El propósito de esta revisión es reunir distintos conceptos que expliquen la asociación que mantienen estas dos patologías, sus etiologías, el cuadro clínico que presenta la hipersensibilidad dentinaria para poder realizar un diagnóstico diferencial y las distintas opciones de tratamiento para realizar un adecuado manejo de esta condición que incluyen desde recursos terapéuticos que buscan resolver la sintomatología hasta procedimientos quirúrgicos que resultan más invasivos y que se enfocan en tratar el factor predisponente como es la recesión gingival misma (AU)

Dentin exposure level periodontal tissues can cause pain to diff erent stimuli, a situation which can hinder the daily lives of patients who suff er, in addition to having aesthetic complications that can damage self-esteem. Dental hypersensitivity has a multifactorial etiology associated being the main risk factor gingival recession, the common clinical situation observed in much of the population. The purpose of this review is to bring together various concepts that explain the association that maintain these two pathologies, their etiologies, clinical picture presented dentine hypersensitivity to perform a diff erential diagnosis and treatment options for proper management of this condition ranging from therapeutic procedure seeking to resolve the symptoms to surgical procedures that are more invasive and that focus on treating the predisposing factor such as the gingival recession itself (AU)

Tratamiento de recesión única de clase III con injerto libre subepitelial mediante técnica de colgajo de doble papila reposicionado: informe de un caso clínico / Treatment of a single Class III recession combining free subepithelial connective tissue graft and a double papilla repositioned flap: report of a clinical case

Objetivo: mostrar y evaluar los resultados clínicos de un procedimiento de cirugía plástica periodontal, efectuada para cubrir una recesión radicular de clase III de Miller, con una técnica bilaminar. Además, analizar el aumento de la banda de encía y el cambio de biotipo gingival de la pieza dentaria. Caso clínico: paciente femenino de 30 años de edad, con una recesión gingival de Clase III de Miller por vestibular de la pieza 43 que no sobrepasa la línea mucogingival, con pérdida interproximal de tejidos duros y blandos. El tratamiento consiste en un colgajo de doble papila a espesor parcial, con injerto libre subepitelial tomado del paladar, con seguimiento a 1 año. Conclusiones: la técnica bilaminar es una solución viable en casos de recubrimiento radicular poco predecibles, como la recesión de clase III de Miller. El biotipo gingival se vio engrosado y la encía queratinizada no sufrió variaciones.

Gingival recession: its causes and types, and the importance of orthodontic treatment

abstract Gingival recession has direct causes and predisposing factors. Orthodontic treatment is able to prevent recession and even contribute to its treatment, with or without periodontal approach, depending on the type and severity of gingival tissue damage. There is no evidence on the fact that orthodontic treatment alone might induce gingival recession, although it might lead the affected teeth (usually mandibular incisors or maxillary canines) to be involved in situations that act as predisposing factors, allowing direct causes to act and, therefore, trigger recession, especially when the buccal bone plate is very thin or presents with dehiscence. Several aspects regarding the relationship between orthodontic treatment and gingival recession have been addressed, and so has the importance of the periosteum to the mechanism of gingival recession formation. Clinical as well as experimental trials on the subject would help to clarify this matter, of which understanding is not very deep in the related literature.

Resumo As recessões gengivais têm causas diretas e fatores predisponentes. O tratamento ortodôntico pode prevenir as recessões e, até, contribuir para o seu tratamento, com ou sem uma abordagem por parte do periodontista, dependendo do tipo e da severidade do comprometimento dos tecidos gengivais. Não há evidências de que o tratamento ortodôntico possa induzir, de forma primária, as recessões gengivais, muito embora possa levar os dentes envolvidos (comumente, os incisivos inferiores e os caninos superiores) a situações que ajam como fatores predisponentes para que as causas diretas possam atuar e produzir recessões - em especial, quando deixa-se uma tábua óssea vestibular muito fina ou, até, com deiscência. Vários aspectos da relação entre o tratamento ortodôntico e as recessões gengivais já foram abordados, assim como a importância do periósteo no mecanismo de formação delas. Trabalhos clínicos e experimentais sobre o assunto ajudariam a esclarecer o assunto, que ainda se apresenta muito pouco aprofundado na literatura pertinente.

Recesión única en el maxilar superior, tratamiento mediante colgajo desplazado lateral avanzado coronalmente: reporte de casos / Isolated recession in the upper maxillary, treatment by means of coronally advanced lateral flap: report of cases

Describir el tratamiento quirúrgico realizado, como también evaluar la cicatrización y cobertura gingival obtenida en dos pacientes con recesiones gingivales únicas en vestibular del maxilar superior. Casos clínicos: en los dos casos presentados en este reporte se trataron quirúrgicamente dos recesiones clase I y II de Miller, mediante colgajo desplazado lateral avanzado coronalmente. Conclusiones: es de suma importancia preservar y/o recuperar los tejidos gingivales, no solamente desde el punto de vista estético sino también funcional. Debemos considerar los factores anatómicos locales que influyen en el resultado final y hacer un diagnóstico correcto del caso. Aprovechando las ventajas de esta técnica disminuiremos los fracasos...

Morphological patterns of gingival recession in adult chilean population / Patrones morfológicos de recesiones gingivales en población chilena adulta

The aim of this study was to determine the prevalence of morphological patterns of gingival recession, attachment loss, and type of interdental papilla in adult subjects of different age in a Chilean population. A total of 105 patients with ages ranging from 18 to 64 years of both sexes participated in our study. The prevalence of gingival recession was 92.38 percent, affecting 530 teeth. The morphological pattern of gingival recession most common was class II (34.94 percent), followed by types III, I and IV. According to ANOVA test, differences were significant in relation to the mean number of affected teeth. Of those who had recessions, females had a slightly higher prevalence. The range 18-34 years showed a prevalence of 82.22 percent and from 35 years increased to 100 percent. The vertical extent between 0-3mm and horizontal between 4-7mm were the most prevalent affected 88.68 percent and 59.05 percent of teeth, respectively. Attachment loss was 3-4mm in 316 teeth (59.62 percent), and the most prevalent interdental papillae on the different patterns was type I (40.18 percent) followed by type III (21.88 percent). Differences were statistically significant (p=0.001) in relation to age of individuals who presented diferent morphological patterns of gingival recession. For the others parameters (depth and width of the recession, attachment loss) we found no statistically significant differences with a confidence interval of 95 percent. These findings represent a contribution for the evaluation of gingival recession in our population, particularly in the anterior aesthetic zone.

El objetivo fue determinar los patrones morfológicos de recesión gingival más prevalentes junto al grado de pérdida de inserción clínica y tipo de papila interdentaria en una muestra de población chilena. Se evaluaron 105 pacientes de ambos sexos, con edades entre 18 y 64 años. La prevalencia de recesión gingival fue del 92,38 por ciento, afectando 530 dientes. El patrón morfológico de recesión más frecuente fue el clase II (34,94 por ciento), seguido por los tipos III, I y IV. Según la Prueba de ANOVA, fueron encontradas diferencias significativas en relación a las medias de dientes afectados entre los individuos que presentaban recesión. El sexo femenino presentó una prevalencia ligeramente mayor. En el rango de 18-34 años se observó una prevalencia de 82,22 por ciento y desde los 35 años aumentó al 100 por ciento. La extensión vertical entre 0-3mm y horizontal entre 4-7mm fueron las más prevalentes y afectaron al 88,68 por ciento y 59,05 por ciento de los dientes, respectivamente. La perdida de inserción más habitual fue del rango 3-4mm en 316 dientes (59,62 por ciento ). El tipo de papila interdentaria en las recesiones gingivales fue del tipo I (40.18 por ciento) seguido por el tipo III (21.88 por ciento). Se encontraron diferencias estadísticamente significativas (p=0.001) en relación a la edad de los individuos que presentaron estos patrones morfológicos de recesión gingival y quiénes no. Estos resultados representan una contribución para la evaluación de la recesión gingival en nuestra población, particularmente en la zona estética anterior.

Cirugía plástica periodontal: tratamiento de las retracciones gingivales / Periodontal plastic surgery: treatment of gingival recessions

La retracción gingival es el desplazamiento apical de margen gingival con la consiguiente exposición radicular, ocasionando hipersensibilidad, posibilidad de caries radicular y problemas estéticos. La cirugía plástica periodontal incluye procedimientos para su resolución. Su tratamiento requiere un análisis minucioso de las variables que determinan su ocurrencia y la consideración de las expectativas del paciente, a fin de seleccionar el procedimiento más adecuado y el planteo de las posibilidades de logro.

An evaluation of the effectiveness and predictability of transpositional flap vs connective tissue graft for coverage of Miller's class-I and class-II facial marginal tissue recession lesions: A clinical study.

Background: There has been no study to date comparing the effectiveness and predictability of transpositional flap (TF) with that of the gold standard connective tissue graft (CTG) for root coverage. This study was performed during 2001-2002 at Government Dental College and Hospital, Mumbai India. Objectives: To evaluate the effectiveness and predictability of TF vs CTG for coverage of Miller's class I and class II facial marginal tissue recession defects. Materials and Methods: Twenty cases fulfilling the selection criteria were identified and randomly allotted to two groups: group I (TF, 10 cases) and group II (CTG, 10 cases). Registered parameters included plaque index (PI), defect-specific plaque index (DPI), gingival index (GI), defect-specific gingival index (DGI), recession depth (RD), recession width (RW), probing depth (PD), attachment level (AL), width of keratinized tissue (KT), percentage defect coverage (DC), and percentage root coverage (RC). Results: For group I: preoperative PI, DPI, GI, DGI, RD, PD, KT, and RC were 0.38±0.14, 1.1±0.57, 0.02±0.02, 0.36±0.29, 4.45±2.0, 1.5±0.71, 1.45±1.30, and 68.57±14.36, respectively; the corresponding postoperative values were 0.38±0.11, 0.36±0.29, 0.01±0.01, 0.10±0.16, 3.2±2.44, 1.1±0.32, 2.65±1.03, and 77.40±17.23. For group II the preoperative PI, DPI, GI, DGI, RD, PD, KT, and RC were 0.77±0.5, 1.53±0.63, 0.12±0.18, 0.59±0.62, 4.95±1.59, 1.9±0.74, 0.50±1.08, and 65.05±11.22, respectively, and the corresponding postoperative values were 0.49±0.32, 0.8±0.50, 0.03±0.53, 0.03±0.10, 0.90±0.88, 1.2±0.42, 4.4±1.07, and 93.65±6.18, respectively. Conclusion: The TF technique for coverage of single tooth buccal recession defects of Miller's class I and class II types in mandibular anterior teeth was neither effective nor predictable in defect coverage and defect elimination.

Combination of orthodontic movement and periodontal therapy for full root coverage in a miller class iii recession: a case report with 12 years of follow-up

One of the main purposes of mucogingival therapy is to obtain full root coverage. Several treatment modalities have been developed, but few techniques can provide complete root coverage in a class III Miller recession. Thus, the aim of this case report is to present a successful clinical case of a Miller class III gingival recession in which complete root coverage was obtained by means of a multidisciplinary approach. A 17-year-old Caucasian female was referred for treatment of a gingival recession on the mandibular left central incisor. The following procedures were planned for root coverage in this case: free gingival graft, orthodontic movement by means of alignment and leveling and coronally advanced flap (CAF). The case has been followed up for 12 years and the patient presents no recession, no abnormal probing depth and no bleeding on probing, with a wide attached gingiva band. A compromised tooth with poor prognosis, which would be indicated for extraction, can be treated by orthodontic movement and periodontal therapy, with possibility of 100% root coverage in some class III recessions.

Um dos principais objetivos da terapia mucogengival é atingir a cobertura completa da raiz. Diversas modalidades de tratamento têm sido desenvolvidas, mas poucas técnicas podem obter a cobertura total da raiz em uma recessão gengival classe III de Miller. Assim, o objetivo deste relato é apresentar um caso de sucesso clínico de uma recessão gengival classe III de Miller na qual foi obtida a cobertura completa da raiz por meio de uma abordagem multidisciplinar. Uma jovem de 17 anos sexo feminino, leucoderma, foi encaminhada para tratamento de uma recessão gengival no incisivo central inferior esquerdo. Para a cobertura radicular foi planejado: enxerto gengival livre, movimento ortodôntico por meio de alinhamento e nivelamento e retalho reposicionado coronariamente (CAF). Este caso tem sido acompanhado por 12 anos e o paciente apresenta ausência de recessão, sem profundidade de sondagem anormal e sem sangramento à sondagem com ampla faixa de gengiva inserida. Dentes comprometidos e com mau prognóstico, que seriam extraídos em muitos casos, podem ser tratados por meio de movimento ortodôntico e terapia periodontal. 100% de cobertura da raiz é possível e pode ser conseguida em alguns casos de recessão gengival classe III.

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.

Periodontal parameters and BANA test in patents with chronic renal failure undergoing hemodialysis

OBJECTIVES: The aim of this study was to analyze the periodontal parameters of patients with chronic renal failure. MATERIAL AND METHODS: The periodontal status of 16 Brazilian patients aged 29 to 53 (41.7±7.2) years with chronic renal failure (CRF) and another matched group of 14 healthy controls with periodontitis was assessed clinically and microbiologically. Probing pocket depth (PPD), gingival recession (GR), dental plaque index (PLI), gingival index (GI), and dental calculus index (CI) were the clinical parameters recorded for the entire dentition (at least 19 teeth), while the anaerobic periodontopathogen colonization in four sites with the highest PPD was evaluated using the BANA test ("PerioScan"; Oral B). RESULTS: The results for the CRF group and control group, respectively were: PPD: 1.77±0.32 and 2.65±0.53; GR: 0.58±0.56 and 0.51±0.36; PLI: 1.64±0.56 and 1.24±0.67; GI: 0.64±0.42 and 0.93±0.50; CI: 1.17±0.54 and 0.87±0.52. Comparison between groups using the "t" test revealed a significantly increased PPD (p<0.001) in the control group. Comparison of the other clincial parameters by the Mann-Whitney test showed differences only for PLI, which was significantly higher (p<0.05) in the CRF group. Spearman's test applied to each group showed a positive correlation among all clinical parameters, except for GR (p<0.05). None of the groups showed any correlation between GR and GI, while a significant negative correlation between GR and PPD was observed for the CRF group. The percentage of BANA-positive sites was 35.9 percent for the CRF group and 35.7 percent for the control group. The BANA test correlated positively with PPD only in the control group and with GR only in the CRF group. CONCLUSIONS: In spite of a higher PLI and dense anaerobic microbial population even in shallow PPD, patients with CRF exhibited better periodontal conditions than periodontitis patients, which is an evidence of altered response to local irritants.

Uso de la membrana dérmica acelular en estética periodontal: segunda parte / The use of acellular dermal matrix in periodontal esthetics: second part

Este artículo comunica un caso clínico con postoperatorio de 5 años, en el cual se trataron con membrana dérmica acelualr recesiones gingivales múltiples Miller I y II, y escaso ancho de encía insertada. Paciente de 32 años de edad, fue derivada para el tratamiento de estos defectos en el maxilar inferior de ambos lados, que le provocaban hipersensibilidad extrema en todos los elementos dentarios con superficies radiculares expuestas. Luego de la terapia básica, instrucción en una técnica de higiene bucal atraumática y control de los factores oclusales, se realizó un colgajo desplazado coronario y colocación de AlloDerm(R) como material de injerto. El aloinjerto fue posicionado en el sector izquierdo del maxilar inferior por su lado conectivo, según especificaciones del fabricante y en el sector derecho por su lado basal, según Harris(1). A 5 años de la cirugía, en ambos lados se mantuvo no sólo el recubrimiento radicular logrado, sino también un adecuado ancho de encía queratinizada. En este caso clínico, el uso de AlloDerm en recesiones gingivales múltiples, independientemente del lado de la membrana usado, resultó un tratamiento estable a largo plazo.

Free gingival graft in the treatment of class III gingival recession.

AIM: The purpose of this study was to assess the success and predictability of root coverage and esthetics obtained with free gingival grafts (FGGs) in the treatment of early class III gingival recessions for a period of 12 months. MATERIALS AND METHODS: Ten patients contributed to 12 sites, each with early class III recession with interdental bone loss < or = 4 mm from cemento enamel junction(CEJ). Clinical parameters recorded at baseline and at 1, 6, and 12 months were probing depth (PD), recession depth (RD), recession width (RW), and clinical attachment level (CAL). RESULTS: Reduction of recession resulted in a significant gain in CAL and PD at the end of 12 months. A statistically significant mean root coverage of 41.25 +/- 21.07% was obtained at the end of 12 months. A statistically significant improvement in Visual Analog Scale score was seen after a 12-month follow-up period. CONCLUSION: In a south Indian population, early class III gingival recessions treated with FGG procedures resulted in 40-50% root coverage with fairly acceptable esthetics.

Gingival margin alterations and the pre-orthodontic treatment amount of keratinized gingiva

The purpose of this retrospective study was to associate the amount of keratinized gingiva present in adolescents prior to orthodontic treatment to the development of gingival recessions after the end of treatment. The sample consisted of the intra-oral photographs and orthodontic study models from 209 Caucasian patients with a mean age of 11.20 ± 1.83 years on their initial records and 14.7 ± 1.8 years on their final records. Patients were either Angle Class I or II and were submitted to non-extraction orthodontic treatment. Gingival recession was evaluated by visual inspection of the lower incisors and canines as seen in the initial and final study models and intra-oral photographs. The amount of recession was quantified using a digital caliper and the observed post-treatment gingival margin alterations were classified as unaltered, coronal migration of the gingival margin or apical migration of the gingival margin. The width of the keratinized gingiva was measured from the mucogingival line to the gingival margin on the pre-treatment photographs. The teeth that developed gingival recession and those that did not have their gingival margin position changed did not differ in relation to the initial amount of keratinized gingiva (3.00 ± 0.61 and 3.5 ± 0.86 mm, respectively). Paradoxically, teeth that presented a coronal migration of the gingival margin had a smaller initial amount of keratinized gingiva (2.26 ± 0.31 mm). The mean amount of initial keratinized gingiva did not predispose lower incisors and canines to gingival recession.

O objetivo deste estudo retrospectivo foi associar a quantidade de gengiva ceratinizada existente em adolescentes pré-tratamento ortodôntico e o desenvolvimento de recessões gengivais pós-tratamento ortodôntico. A amostra consistiu de fotografias intra-orais e modelos de estudo de 209 pacientes leucodermas com idades médias de 11,20 ± 1,83 anos nos exames iniciais e 14,7 ± 1,8 anos nos exames finais. Os pacientes eram Classe I ou II de Angle e foram submetidos a tratamento ortodôntico sem extrações. As recessões gengivais foram avaliadas por inspeção visual dos incisivos e caninos inferiores nas fotografias e nos modelos de estudo iniciais e finais dos pacientes. As alterações da margem gengival pós-tratamento foram medidas com paquímetro digital e subdivididas em inalterada, migração coronal da margem gengival, ou migração apical da margem gengival. A quantidade de gengiva ceratinizada foi medida da linha mucogengival à margem gengival nas fotografias pré-tratamento ortodôntico. Tanto os dentes que desenvolveram recessões gengivais como aqueles que não tiveram a posição da margem gengival alterada não diferiram entre si quanto à quantidade de gengiva ceratinizada inicial (3,00 ± 0,61 e 3,5 ± 0,86 mm, respectivamente). Contraditoriamente, dentes que apresentaram migração coronal da gengiva tinham uma quantidade menor de gengiva ceratinizada inicial (2,26 ± 0,31 mm). A quantidade média de gengiva ceratinizada inicial não predispôs a recessões gengivais de incisivos e caninos inferiores.

Root coverage with free gingival autografts--a clinical study.

AIM: To assess the percentage of root coverage with autogenous free gingival grafts. MATERIALS & METHODS: Ten non-smoking patients with Miller's class I or class II recessions were included in the study. The clinical parameters such as recession depth, recession width, probing pocket depth, clinical attachment level and width of the keratinized gingiva were recorded at the baseline, at the end of 1 month, 3 months, and 6 months after the surgical procedure. Autogenous free gingival grafts harvested from the palatal mucosa were used to cover the denuded roots. RESULTS: Four out of ten sites showed 100% root coverage. A mean percentage of 80.3% of root coverage was achieved.

Recesión marginal gingival: etiología, consideraciones histológicas, clasificación y técnicas de tratamiento / Marginal gingival recession: etiology, histologic considerations, classification and treatment techniques

La recesión marginal gingival describa la localización del margen gingival libre apical a la unión cementoamélica; está asociada a estética indeseable, abrasión superficial radicular, sensibilidad y caries radicular. Uno de los objetivos de la terapia periodontal es corregir quirúrgicamente las recesiones; la eficacia y predecibilidad de algunas técnicas son consideraciones importantes para el paciente y el clínico. Una variedad de procedimientos quirúrgicos se han descrito como métodos efectivos para cubrir las superficies radiculares expuestas. El propósito de este artículo es presentar las causas que ocasionan la recesión, sus consideraciones histológicas, su clasificación, indicaciones y contraindicaciones para el cubrimiento de las recesiones y evaluación de las ténicas de tratamiento que se utilizan para cubrirlas

Nueva clasificación de las enfermedades periodontales / New classification of periodontal diseases

Este artículo resume la nueva clasificación de enfermedades periodontales propuestas recientemente por la Academia Americana de Periodontología. El sistema de clasificación es necesario para que en un marco de referencia científico se permita ordenar las entidades por sus propias características etiológicas y patogénicas que deriven a un plan tratamiento moderno basado en las actuales evidencias de enfermedad periodontal

Tratamiento de una recesión gingival localizada adyacente a una zona edéntula mediante un colgajo posicionado lateral. Revisión y reporte de un caso / Treatment of a localized gingival recession, adjacent to an edentulous zone, by a lateral positioned flap. Review and report of a case

Las recesiones del tejido marginal han sido tratadas a través de los años por medio de diferentes procedimientos mucogingivales, dentro de los que se encuentran los colgajos posicionados laterales. Este artículo presenta la revisión de esta técnica y el reporte de un caso en un paciente con un defecto mucogingival localizado adyacente a una zona edéntula. El paciente fue evaluado en un examen inicial, en la reevaluación, 1, 3 y 6 meses después de llevar a cabo la terapia quirúrgica. Los resultados demostraron un mejoramiento de todos los parámetros clínicos evaluados (Indice de placa, índice de sangrado, nivel de inserción, profundidad al sondaje y nivel del margen gingival), logrando una cobertura radicular aproximada del 80 por ciento