RESUMO
Abstract The purpose of this study was to compare the outcomes of a modified gingival graft technique, in which the released flap is positioned and sutured over the graft, with the conventional free gingival graft (FGG) procedure, when both are used for gingival augmentation. A 12-month, multicenter parallel randomized controlled trial was conducted. Subjects with buccal RT2 gingival recessions and keratinized tissue width (KTW) < 2 mm in at least one mandibular incisor were randomized to control group (n = 20; conventional FGG) or test group (n = 20; modified FGG; flap sutured over FGG using sling sutures). The primary outcome (KTW) was measured at baseline and after 3, 6 and 12 months, as was keratinized tissue thickness (KTT). Postoperative pain (POP) and analgesic intake were also recorded. Both techniques promoted a significant increase in KTW and KTT when compared to baseline (p < 0.05) with no significant differences between groups (KTW change of 6.1±1.5 mm and 5.4±1.6 mm, for control and test, respectively; p=0.16). However, test group patients reported less POP after 7 days and used less analgesic medication than control group patients (p < 0.05). We concluded that the modified FGG was comparable to conventional FGG in augmenting keratinized tissue width and thickness at mandibular incisors, but resulted in less patient morbidity.
RESUMO
A 41-year-old Caucasian male smoker presented a red and white plaque on the left jugal mucosa suggestive of oral erythroleukoplakia (OEL). Biopsy followed by microscopic examination revealed carcinoma in situ. Since OEL is considered a precancerous lesion with a high malignant transformation potential, the present case set out to discuss the challenges in diagnosing the condition and choosing the most appropriate treatment. The discussion deals with issues such as whether there is a limit for choosing either a radical or a more conservative approach to treatment and the importance of using a procedure that allows a microscopic examination of the entire lesion. Carcinoma in situ associated with OEL made the treatment planning even more complex in the present case. In order to avoid a mutilating approach, multiple excisions with safety margins were performed, and the patient was instructed not to smoke. A strict 12-month follow-up shows no signs of recurrence of the OEL... (AU)