386 resultados para recesión gingival


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Background: This article reports a clinical case with a 3-year follow-up in which a subepithelial connective tissue graft (SCTG) was used with the tunnel technique to treat multiple gingival recessions, and describes a technique used to enlarge the extension of the graft.Methods: A 41 -year-old female patient was referred for evaluation and treatment of maxillary multiple recessions. Following basic therapy, the plaque index was 23%, and the gingival index was 12%. Thus, SCTG with the tunnel technique was proposed to provide root coverage of Miller Class I recession on teeth #8 through #11 and a Miller Class III recession on tooth #12. After the donor area had been prepared, SCTG was removed and split cross-sectionally to lengthen it. The graft was placed through the tunnel and sutured.Results: Two weeks after the surgical procedure, the tissue color was nearly homogeneous with some reddish regions where the connective tissue was left uncovered, and there were no signs of incisions or suture marks. After 3 years of follow-up, the mean coverage of the recessions was 2.2 +/- 0.7 mm (74.2%), which corresponded to the gain of keratinized tissue. In addition, a gain in tissue thickness was observed.Conclusion: In a long-term evaluation, the tunnel technique with the elongated SCTG was used successfully for treatment of multiple gingival recessions with an increase of the soft tissue volume and gain of keratinized tissue.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Background: the purpose of this study was to evaluate the effect of a selective cyclooxygenase-2 inhibitor on the progression of alveolar bone loss in an experimental periodontitis model in rats.Methods: One hundred eighty (180) Wistar rats were separated into 3 experimental groups. Cotton ligatures were placed at the gingival margin level of lower right first molars. The rats were randomly assigned to one of the following groups that received: a daily oral dose of 10 mg/kg body weight of celecoxib (Ce1); 20 mg/kg body weight of celecoxib (Ce2); or 10 ml/kg of saline solution (C). Serum levels of celecoxib and white blood cell count were determined. Standardized digital radiographs were taken after sacrifice at 3, 5, 10, 18, and 30 days to measure the amount of bone loss around the mesial root surface of the first molar tooth in each rat.Results: Two-way analysis of variance (ANOVA) indicated that groups treated with celecoxib had significantly less bone loss compared to controls (P <0.0001) and that there was a significant interaction between treatment with celecoxib and time (P <0.03). Post-hoc comparisons showed that in both groups treated with celecoxib, the bone loss became significant only after 10 days of ligature placement, while in the control group it was already significant after 5 days. However, differences in mean bone loss between control and Ce1 were significant only at 18 days and, between control and Ce2, at 5 and 18 days. There was no significant difference in bone loss among experimental groups at the end of the experimental period.Conclusion: These data provide evidence that systemic therapy with celecoxib can modify the progression of experimentally induced periodontitis in rats.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Background and Objective:Platelets contain factors, including VEGF and endostatin, that can modulate the healing process. We evaluated the effects of severe thrombocytopenia on periodontal healing in rats and determined the contribution of VEGF and endostatin to the healing process.Material and Methods:Rats were distributed into three test groups and two control groups. Cotton ligatures were placed at the gingival margin level of the lower first molar in the test groups. Sham-operated rats and rats in one of the periodontitis groups were killed 15 days later. Rats in the remaining two periodontitis groups had the ligatures removed in order to study the spontaneous recovery from the periodontal disease 15 days later, and these rats were treated with rabbit antiplatelet serum, in order to induce thrombocytopenia, or normal rabbit serum. An additional group without ligatures received antiplatet serum in the same period.Results:After ligature removal, rats treated with normal rabbit serum showed reduced myeloperoxidase activity, decreased alveolar bone loss and increased numbers of blood vessels. Thrombocytopenia caused a delay in alveolar bone regeneration, a decrease in the number of vessels and a modest decrease in myeloperoxidase activity. In the rats with periodontitis, serum endostatin concentrations were slightly decreased and serum VEGF remained unchanged compared with sham-operated animals. After ligature removal, a significant VEGF increase and endostatin decrease were observed in the rats treated with normal rabbit serum. Thrombocytopenia led to a dramatic fall in both VEGF and endostatin concentrations.Conclusion:Thrombocytopenia leads to a delay of periodontal healing in the situation of experimental periodontitis, which might be mediated in part by a decrease in the serum concentration of VEGF and endostatin derived from the platelets. However, other factors derived from the platelets may also have contributed to a delay of periodontal healing in the rats with thrombocytopenia.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Os aumentos gengivais podem ser decorrentes de reações teciduais a estímulos idiopáticos, patológicos e farmacológicos. O objetivo desse trabalho foi avaliar morfometricamente e estereologicamente a ação da fenitoína (Fen) e ciclosporina (CsA) sobre os tecidos gengivais de ratos. Dez ratos receberam, por via intraperitonial, Fen na dose inicial de 2 mg/kg de peso corporal/dia, aumentando 2 mg a cada duas semanas, durante 60 dias. em outros 10 ratos, administraram-se, por via subcutânea, 10mg/kg de peso corporal/dia de CsA, durante o mesmo período do grupo anterior. Os valores morfométricos e estereométricos dos tecidos gengivais dos ratos tratados com CsA foram significativamente maiores quando comparado com os valores dos tecidos gengivais do grupo tratado com Fen. Esses resultados sugerem que a CsA na dose utilizada é mais eficaz no desenvolvimento do aumento gengival em ratos, podendo estar atuando na proliferação de fibroblastos e no desequilíbrio fisiológico da síntese de fibras colágenas.

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The purpose of this study was to determine the effect of two different preventive oral hygiene education and motivation programmes on the plaque and gingival index, as well as denture hygiene of patients provided with removable partial denture (RPD) during a 12-month follow-up.A total of 53 partially edentulous patients were recruited for this study. The presence or absence of plaque and gingival bleeding by gentle probing was scored on all tooth surfaces at the preliminary visit. The plaque and gingival indexes were measured using the Loe index. Following treatment, the patients were randomly divided into three groups. In Control Group I, subjects were instructed to continue their personal oral hygiene routine. In Group II, participants were given verbal instructions and a self-educational manual on oral hygiene without illustrations. In Group III, oral hygiene guidance was delivered using a combination of verbal instructions and a self-teaching manual. To evaluate the effect of the different modes of instruction, the presence or absence of plaque and gingival bleeding was scored on all tooth surfaces (day zero examination) and re-examined 7, 15 and 30 days, 3, 6 and 12 months following RPD placement. The state of denture hygiene was evaluated 7, 15 and 30 days and 3, 6 and 12 months following rehabilitation. Parametric statistics was applied to dental plaque and gingival indexes. For accumulation of plaque and calculus on the RPD, non-parametric statistic was applied.The frequency of plaque found during the preliminary visit was higher than that found in the other periods. With regard to gingival index, significant difference was found between the preliminary visit examination and other periods. There was a significant difference in the plaque accumulation on the denture surface between groups I and III.The different methods of oral hygiene instruction used in this study indicate that the type of education was not of significant importance.

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Statement of problem. Sealing ability and bond strengths of total-etch and self-etch dentin adhesives used for immediate dentin sealing have not been assessed and established.Purpose. The purpose of this study was to determine the effectiveness of immediate dentin sealing (IDS) using total-etch or self-etch dentin adhesives on microleakage and microtensile bond strength.Material and methods. Twenty recently extracted molars were selected, and standard MOD inlay preparations were made with the gingival margins located below the cemento-enamel unction. The teeth were assigned to 4 experimental groups (n=5) according to the indirect composite restoration cementation technique used: (1) immediate dentin sealing with Adper Single Bond (TEBI); (2) conventional adhesive cementation technique using Adper Single Bond (TEAI); (3) immediate dentin sealing using Adper Prompt L-Pop (SEBI); or (4) conventional adhesive cementation technique using Adper Prompt L-Pop (SEAI). The restored teeth were thermal cycled 1,000 times between 5 degrees and 55 degrees C and then immersed in 50% ammoniacal silver nitrate. Three specimens per restoration were evaluated for microleakage, according to predefined scores, and submitted to Friedman's test (alpha-.05). The specimens were then sectioned to obtain 0.8 +/- 0.2-mm-thick sticks (with n ranging from 32 to 57 specimens) and submitted to microtensile bond strength (mu TBS) testing. The obtained data were submitted to 2-way ANOVA test (alpha=.05).Results. None of the experimental groups demonstrated complete elimination of marginal microleakage. There were significant differences in microleakage of the tested adhesives (P>.001). IDS microleakage scores were similar to those obtained using the conventional cementation technique (CCT) for both adhesives. The highest mean bond strengths were obtained with TEBI (51.1 MPa), whereas SEAI showed the lowest mean bond strengths (1.7 MPa). IDS resulted in significantly higher bond strengths than CCT (P<.001).Conclusions. Total-etch and self-etch adhesives have a significant effect on IDS. IDS resulted in high bond strengths for both adhesives; however, the microleakage was similar to that obtained with CCT (J Prosthet Dent 2009;102:1-9)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Objective: To evaluate the effect of periodontal therapy on clinical parameters as well as on total salivary peroxidase (TSP) activity and myeloperoxidase (MPO) activity in the gingival crevicular fluid (GCF) of patients with type 2 diabetes mellitus (DM2) and of systemically healthy individuals.Material and Methods: Twenty DM2 subjects with inadequate metabolic control (test group) and 20 systemically healthy individuals (control group), both groups with chronic periodontitis, were enrolled. Periodontal clinical parameters, namely periodontal probing depth (PD), clinical attachment level (CAL), visible plaque index (VPI), bleeding on probing (BOP), gingival bleeding index (GBI) and presence of suppuration (SUP), as well as TSP activity and GCF MPO activity, were assessed before and 3 months after non-surgical periodontal therapy.Results: At baseline and 3 months post-treatment, the test group presented a higher percentage of sites with VPI and BOP (p < 0.01). MPO activity in the GCF presented lower values (p < 0.05) for the test group at both baseline and the post-treatment period. The periodontal treatment resulted in a significant improvement of most clinical and enzymatic parameters for both groups (p < 0.05).Conclusions: In both groups, the periodontal therapy was effective in improving most clinical parameters and in reducing salivary and GCF enzymatic activity. The diabetic individuals presented lower MPO activity in the GCF.