Uma opção terapêutica para o aumento da faixa de gengiva inserida: o enxerto de tecido conjuntivo livre

Several periodontal procedures have been described in the literature to correct mucogingival alterations or to achieve root coverage. The epithelized free gingival graft is a well established periodontal surgery to increase the width of keratinized gingiva with good stability in the long term follow up. However, this procedure is not commonly used in aesthetic areas since the grafted tissue presents differences of color and contrast. The free connective tissue graft emerges as a viable option to increase attached gingiva in areas where aesthetics results are required. The removal of an epithelized free gingival graft from the hard palate region creates a sore and raw surgical wound that slowly repairs, while the connective tissue graft produces only a line of incision that can be easily sutured promoting a more confortable outcome for the patient. This paper aims to report a case where a free connective tissue graft was used to increase the width of attached gingiva in a tooth with gingival recession. This technique presented satisfactory esthetics results, with a better contrast and color matching with the surrounding tissues.

Recobrimento radicular por enxerto de tecido conjuntivo subepitelial

Gingival recession lesions are characterized by apical migration of gingival margin with consequent exposure of the root surface, which constitutes an aesthetic problem for the patient. Several surgical techniques have been used for the root coverage, and the technique of subepithelial connective gingival graft has greater predictability of root coverage and best aesthetic results with fewer postoperative side effects in relation to the epithelial free gingival graft. The goal of this case repot is to describe the technique of subepithelial connective tissue graft and demonstrates its result in a coverage Miller class I root recessions. After two years we can see excellent root coverage with significant aesthetic improvement of the case. The free subepithelial connective tissue graft technique was effective in coverage Miller class I root recession presented in this clinical case.

Comparação de dois tipos de retalho para enxerto de tecido conjuntivo no tratamento de recessões gengivais: estudo clínico controlado randomizado

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

Enxerto de tecido conjuntivo para correção da margem peri-implantar

Soft tissue recessions frequently cause esthetic disharmony and dissatisfaction. The results of coverage in peri-implant sites, in comparison with soft tissue coverage around a tooth, is less predictable. This clinical report describes the correction of an esthetic problem with a single-tooth implant-supported using a subepithelial connective tissue graft (SCTG) combined with the re-establishment of a new limit of gingival margin, and emergence crown profile. After anamnese and clinical exam it was observed an implant in the region of tooth 22 in vestibular position to alveolar ridge with a recession of 5 mm in its vestibular face. In the first cirurgical procedure the crown and the abutment were removed and a SCTG associated with a coronally positioned flap was performed in order to re-establish the limit of gingival margin. After 90 days, it was observed that the tissue in the implant site showed no adequate volume or thickness. Because of that, another SCTG was performed. The reopening procedure to install the healing cap was performed after 4 weeks. Then the prosthesis was installed. At 180 and 360 days postoperative, the implant adjacent tissue presented regular contour, color compatible with health and absence of bleeding. The patient was satisfied with the esthetic result. According to the clinical results and favorable esthetics it was possible to conclude that the use of ETC to correct an esthetic deficiency may be a feasible approach to establish new and stable peri-implant soft tissue contours.

Reação do tecido conjuntivo subcutâneo de ratos ao implante de Artglass®: estudo histológico

Indirect composite resin systems have been routinely recommended for making restorations in distressed patients. The purpose of this study was to evaluate histologically in rats the effect of chronic stress on the reaction of subcutaneous connective tissue after implant of Artglass™. For this purpose, 60 rats were divided into four groups (GI (control), GII (stressed), GIII (Artglass™) and GIV (Artglass™. / stressed) received dorsal subcutaneous implants of polyethylene tubes containing saline solution (GI and GII) or Artglass™ (GIII and GIV). In groups of four animals were sacrificed at 7,14 and 28 days postoperatively. The results allowed to observe more intense inflammatory reaction and tissue organization later in the animals subjected to stress.

Efeito do envelhecimento e do estresse crônico sobre a reação do tecido conjuntivo subcutâneo: estudo histológico em ratos

Physiological functions undergo a gradual retardation that begins around 25-30 years and extends to the death. Moreover, this change affects most severely the activities more complex and more intricate responses to tensions or stress. The purpose of this study was to evaluate histologically in aged rats the effect of chronic stress on the reaction of subcutaneous connective tissue. The purpose of this study was to evaluate histologically in aged rats the effect of chronic stress on the reaction of subcutaneous connective tissue. For this purpose, 60 rats were divided into four groups (GI (control), GII (stressed), GIII (elderly) and GIV (aged / stressed) received dorsal subcutaneous implants of polyethylene tubes containing saline solution. In groups of four animals were sacrificed at 7,14 and 28 days postoperatively. The results allowed to observe more intense inflammatory reaction and tissue organization later in the aged animals subjected to stress.

Influência da aplicação de laser de baixa intensidade no recobrimento radicular associado à técnica de enxerto de tecido conjuntivo em indivíduos fumantes: ensaio clínico controlado randomizado

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

Enxerto de tecido conjuntivo tunelizado – a propósito de um caso clínico

Artigo licenciado com uma Licença Creative Commons - Atribuição Não Comercial Sem Derivações 4.0 Internacional - https://creativecommons.org/licenses/by-nc-nd/4.0/

Caso dermatológico

O nevo do tecido conjuntivo (NTC) é um hamartoma que pode estar associada a várias síndromes, como esclerose tube- rosa, síndrome de Buschke-Ollendorf ou síndrome de Proteus. Casos familiares de NTC têm sido relacionados com maior risco de patologia cardíaca. A apresentação clínica típica caracteriza-se pelo aparecimento de múltiplas placas cor de pele ou amareladas, confluentes no tronco e/ou nos membros, assintomáticas. São geralmente identificados na infância, sem predileção de género. O diagnóstico é confirmado por biopsia cutânea. Estudos adicionais podem ser necessários, de acordo com a presença de sinais ou sintomas sugestivos de uma doença subjacente.

Avaliação macroscópica, microscópica e histomorfométrica do tecido cicatricial pós-cirúrgico de eqüinos submetidos a duas técnicas de neurectomia digital

Avaliou-se macro e microscopicamente o tecido cicatricial pós-operatório de eqüinos submetidos a duas técnicas de neurectomia digital: guilhotina (TG) e stripping (TS). Decorridos 14 meses das cirurgias, foram colhidas 32 amostras de tecido cicatricial em quatro éguas, que tiveram os membros submetidos a ambas as técnicas. À macroscopia, verificaram-se as dimensões da cicatriz do coto proximal e a distância entre os cotos proximal e distal. À microscopia, foi quantificada a proporção de tecido nervoso regenerado por meio de histomorfometria. Não houve diferença nas dimensões do tecido cicatricial, contudo a distância entre cotos foi 5,6 vezes maior na TS (P<0,001). Histologicamente, observou-se a presença de tecido conjuntivo frouxo e denso, macrófagos e fibras nervosas delgadas em ambas as técnicas cirúrgicas. Estruturas nodulares, compostas por fascículos nervosos, foram visualizadas em 56,2% (9/16) das amostras colhidas em nervos submetidos à TS. As porcentagens médias de tecido nervoso no tecido cicatricial foram de 0,31% na TG e 2,6% na TS (P<0,001). Concluiu-se que o retorno à sensibilidade nervosa deve demorar mais a ocorrer após a TS, devido à maior distância entre cotos. A maior proporção de tecido nervoso sugere que essa técnica favorece a regeneração nervosa.

Expressão Imuno-histoquímica de COX-2, EMMPRIN, HIF-1α e GLUT-1 no tecido gengival normal e inflamado

The aim of this study was determine whether an association exists in the gum tissue between the expression of markers of tissue hypoxia (HIF-1α and GLUT-1) with a marker of inflammatory activity (COX-2) and a marker of collagen degradation (EMMPRIN). Was performed immunohistochemistry with antibodies specific for these markers on 60 samples of gingival tissue divided into two groups: gums (n = 26) and gingivitis (n = 34) and expression was analyzed in the epithelial tissue and connective tissue . The reactivity epithelial for COX-2 was observed in only two cases as the HIF-1α, GLUT-1 and EMMPRIN was strongly expressed in the epithelial basal layer and the immunostaining was gradually decreased as the cells away from this layer, and negative in the region suprabasal in most specimens. In connective tissue, and HIF-1α EMMPRIN were strongly positive for most cases analyzed as GLUT-1 was negative in most cases. Immunostaining for COX-2 showed an association with gingival inflammatory infiltrate. The expression of EMMPRIN, HIF-1α and GLUT-1 in normal gums confirms the physiological role of these markers, however there was no association with tissue inflammation. Given the findings we can conclude that the inflammatory changes installed in frames of chronic gingivitis may not be sufficient to activate the factors of hypoxia to levels that can be quantified by immunohistochemical analysis, in addition, the findings are not conclusive in relationship to involvement of EMMPRIN in the secretion of MMPs to degrade collagen in the frames of gingivitis. We suggest the use of technical analysis and quantification of RNA of EMMPRIN and MMPs in order to determine whether collagen degradation observed in gingivitis suffers or not, significant influence of EMMPRIN for secretion and activation of MMPs

Avaliação da biocompatibilidade da seiva do Croton lechleri (sangue de dragão) em tecido subcutâneo de ratos

Pós-graduação em Odontologia - FOA

Perfil de textura em conserva de carne bovina (Corned Beef) submetida a diferentes tratamentos térmicos e sua relação com a concentração das proteínas dos tecidos muscular e conjuntivo colagenoso

Pós-graduação em Engenharia e Ciência de Alimentos - IBILCE

Influência do diltiazem sobre o tecido gengival: estudo histológico e histométrico em ratos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Cicatrização de defeitos de deiscência periodontal associados ao aplainamento radicular tratados com enxerto de tecido conj untivo subepitelial ou membrana bioabsorvível: análise histológica e histométrica em cães

Pós-graduação em Odontologia - FOA