Subepithelial connective tissue graft conjugated to minimally invasive ceramic laminates-1 year follow-up.

OBJECTIVE: Commonly, esthetic procedures involve ceramic laminates and gingivectomy. However, the clinical demand caused by dental wear and gingival recessions due to parafunctional habits is increasing. Thus, in addition to restoring the anatomical and esthetic dental form, it is also necessary to restore the lost gingival volume. CLINICAL CONSIDERATIONS: This article presents a case report of the treatment of a patient with marked incisal wear and gingival recessions. Initially, endodontic treatment of the upper lateral incisors was performed, which presented with pulp necrosis due to the marked wear caused by bruxism. Subsequently, the patient was treated with a subepithelial connective graft by a technique proposed by Zucchelli, along with minimally invasive ceramic laminates and finished with a myorelaxant plaque. CONCLUSIONS: This proposed approach aimed for and achieved esthetic excellence, and full recovery of function, which is of extreme clinical relevance. Ultimately, the stability of the surgery and the laminates after 1 year of follow-up is presented. CLINICAL SIGNIFICANCE: Patients with bruxism in addition to incisal and occlusal wear are more likely to have gingival recessions. The esthetic planning of these patients should contemplate interdisplinarity temporomandibular disorder, periodontics, and dentistry for the recovery of the function and reaching esthetic excellence.

Gingival overgrowth in renal transplant subjects: a 44-month follow-up study.

BACKGROUND: To assess changes in gingival status of renal transplant subjects under immunosuppressive regimens based on cyclosporine (CsA), tacrolimus (Tcr), and sirolimus (Sir). METHODS: From a sample of 135 subjects (baseline examination [BE]), 89 without periodontal treatment, who maintained the immunosuppressive regimen based on the same main agent (CsA=23, Tcr=31, and Sir=35), were reexamined after 44 months (follow-up examination [FE]). Demographic, pharmacologic, and periodontal variables were collected and gingival overgrowth (GO) was assessed by visual examination. RESULTS: In Tcr and CsA groups, although not significant, occurrence of GO decreased (CsA [BE=56.5% and FE=34.8%; P=0.063] and Tcr [BE=19.4% and FE=12.9%; P=0.500]). In addition, the severity of GO decreased significantly in CsA group (mean score BE=10.29 ± 7.70 and mean score FE=0.78 ± 1.38; P=0.003). In Sir group, GO decreased from 17.1% (BE) to 0.0% (FE) (P=not applicable). In total sample, GO was associated with papillary bleeding index (P=0.001) and concomitant use of calcium channel blockers (P=0.029); in CsA and Tcr groups, GO was associated with papillary bleeding index (P=0.029 and 0.033, respectively). CONCLUSIONS: There was no incidence of GO, and a decrease in the occurrence and severity of GO was significant in total sample. This decrease can be attributed to changes in pharmacologic and periodontal variables over this period of time.