Tratamento do sorriso gengival: como estabelecer proporção e harmonia

The etiology of gingival smile is multifactorial and the correct diagnosis eill determine a successful treatment planning. Altered passive eruption occurs during the final stages of tooth eruption, when apical migration of the periodontal tissues does not occur, resulting in a distance > 2mm between the alveolar crest and the cement-enamel juncrion. This change leads to the shortening of the clinical crown and even further may lead to excessive gingival exposure. For treatment, there is a necessity for the combined removal of gingiva and bone tissue. This article discusses the literature on the issue and reports a case where periodontal plastic surgery was performed for the correcrion of a gingival smile.

Tratamento estético periodontal: revisão de literatura sobre alguns tipos de cirurgias

Currently, periodontal aesthetics has been prized for harmony of the smile. The clinical crown lengthening, gingival excess or altered passive eruption, is effectively corrected by periodontal surgery. The purpose of this paper is to show, through a literature review, some types of surgery on clinical crown lengthening and root coverage. Clinical crown lengthening is done to Change the size of the anterior teeth and to optimize the cosmetic result of treatment with new coronal restoration and other cosmetic dental care. In general, the treatment plan and the choice of operative technique begin with careful clinical examination. Recessions tissue can be defined as a displacement of the gingival margin toward the junction mucogingival exposing the root surface. These, when present, impacting on patient comfort by providing the occurrence of cervical dentin hypersensitivity, and the esthetic, the amendment of the gum line. Successful treatment of recessions is based on knowledge of its etiology and assessment of predictability of surgical techniques that aim to root coverage. Through literature review, we can conclude that the types of surgery most often used are: 1) to increase the clinical crown, gingivectomy, flap surgery and gingivoplasty osteotomy, and 2) for root coverage, the use will depend on the amount of gum keratinized and especially the classification of Miller.

Fragmentos cerâmicos

Clínica - International Journal of Brazilian Dentistry

Planejamento multidisciplinar: criação x reprodução

Modern Dentistry offers many alternatives for changing a patient's smile. Using work protocols is essential to obtaining previsibility in the resolution of clinical cases. The aim ofthis paper is to present two clinical protocols for two distinguishable situations, creation and reproduction.

Reparo de uma restauração classe IV com o uso de resina composta nanoparticulada: quatro anos de acompanhamento

O aprimoramento da odontologia estética restauradora está ligado ao desenvolvimento de materiais e técnicas inovadoras, os quais podem oferecer diversos benefícios, incluindo a integração cromática, policromatismo, forma anatômica, função, adequado contato proximal e aumento da integridade marginal. Em função desses aspectos, as restaurações de resina composta, aplicadas de forma direta, tendem a ganhar maior longevidade. Assim, o objetivo do presente relato de caso é fornecer ao leitor a visão dos desafios restauradores envolvidos no reparo de uma fratura classe IV de um dente incisivo superior, utilizando-se um novo sistema de resina composta híbrida nanoparticulada (FiltekTM Supreme - 3M ESPE). Resultados: com base no referido material e técnica, otimizamos a obtenção de resultados satisfatórios alcançados por meio da utilização adequada do sistema adesivo e resina composta, mantidos com sucesso após o acompanhamento de 4 anos. Conclusão: pode-se concluir que, interagindo técnica adequada de aplicação, princípios adesivos básicos e materiais de qualidade, o clínico pode garantir o sucesso na restauração da forma, função e estética de dentes anteriores.

Influência de agentes clareadores na resistência de união de um sistema restaurador ao esmalte em função do tempo de armazenamento em saliva artificial

Pós-graduação em Odontologia Restauradora - ICT

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.

Alteração cromática de resinas compostas laboratoriais submetidas à imersão em diferentes soluções

The pigmentation of indirect composite resins has been one of the most common reasons that lead the restorative treatment to failure. The purpose of this study was to investigate the effect of different solutions on color stability of indirect composite resins. Five brands of indirect composite resins were tested: Adoro, Resilab, Cristobal, Sinfony and Epricord. The samples were immerged in eleven solutions (n=10): common liquid foods (coke soft drink, red wine, coffee and orange juice), mounthrinses (Listerine, Oral-B, Colgate Plax and Periogard) and bleaching agents (carbamide peroxide 16%, 7.5% and hydrogen peroxide 38%) and artificial saliva (control group). The color was measured by a spectrophotometer before and after 7, 14 and 21 days of immersion in common liquid foods, after 12, 24, 36 and 60 hours of immersion in mounthrinses and after 7 and 14 days of immersion in bleaching agents. The Cristobal and Adoro resins showed highest values of ΔE statistically significant compared to the others resin brands. Adoro’s ΔE values changed significantly after the immersion process in red wine and coffee and also between periods measured. The resins Cristobal and Sinfony showed the highest values of ΔE after the immersion process in Listerine with difference statistically significant in comparison to control group. Besides, there was difference statistically significant of the ΔE values  for  Cristobal  after  immersion  in hydrogen peroxide 7,5% in comparison to control group. It can be conclude that all the solutions promoted color change on the indirect composite resins. However, ΔE values  are  whitin  the  values clinically acceptable.

A utilização de abutment de zircônia na reabilitação oral: aspectos protéticos e periodontais

Zirconia abutments are used to obtain satisfactory aesthetic results in implant fixed anterior prostheses when metal abutments promote a grayish mucosal discoloration of the peri-implant soft tissues. However, there is a lack of studies to confirm the clinical performance of the peri-implant soft tissues surrouding zirconia abutments. This study described a case report of a patient treated with implant fixed all-ceramic crown made out on zirconia abutment after 3 years of followup. A 47-year-old female patient was admitted to the dental clinic (Aracatuba Dental School) complaining about the fracture of her implant fixed single crown in the region of the left lateral incisor. The patient chose the replacement of the fractured prosthesis for an allceramic crown. After 3 years of follow-up it was observed that maintenance of the aesthetic results and the peri-implant soft tissue without any inflammation or gingival recessions. Within the limitations of a case report, it can be conclude that zirconia abutments is a effective rehabilitation treatment because it preserves the aesthetics and function through the maintenance of peri-implant tissues.

Saúde bucal de adolescentes que receberam assistência odontológica na primeira década de vida

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Restaurações cerâmicas minimamente invasivas executadas por cirurgiões dentistas com diferentes níveis de experiência profissional: estudo clínico cego, longitudinal e prospectivo

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

Análise do comportamento da cor de restaurações cerâmicas sem metal avaliadas por diferentes métodos: estudo clínico prospectivo

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