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Aim: The aim of the present study was to evaluate the microbial contamination in internal and external walls of cone morse implant walls. Methods: Eleven patients with edentulous mandibular posterior area were selected to received dental implants, divided into groups: submerged (S), non-submerged (NS), and immediately loaded (IL). Microbiological evaluations (microorganisms’ number, aerobic and anaerobic colony forming units (CFU) number and microorganisms’ qualification) were divided into internal and external collection of the implant walls, at different stages: T0 (surgical procedure), T2 (suture removal), T4 (reopening S group), T6 (suture removal S group), and T8 (abutment placement in S and NS). All data were submitted to statistical analyses, with confidence level of 0.05. Results: There was difference in number of microorganisms observed over time within the same group (p < 0.05). A difference was observed in CFU when evaluated within the same group over time (p < 0.05), except for the IL group. In internal collection, a predominance of non-formation of microorganisms was observed at T0 in all groups, while formation of Gram-positive Diplococci and Gram-positive Bacilli was observed at T8 (p>0.05). In external collection, an increase in number of microorganisms was observed at T0. Conclusion: There was no difference in microbial contamination among the evaluated groups. The microorganism’s colonization changed over time.

Previous reports demonstrated the utility of systemic application of growth hormone (GH) in the treatment of bone defects. Very few studies correlated bone repair efficacy with hepatic and renal side effects promoted by locally-delivered GH. The objectives of this study were to assess the bone repair properties along with hepatic and renal adverse effects promoted by local application of GH in a rat model. Thirty-two rats were randomly divided (4 groups; n = 8/group), as follows: (i) AB (autogenous bone + local application of saline solution [SS]), (ii) AB+ (autogenous bone + SS local application + SS irrigation), (iii) AB/GH+ (autogenous bone + SS local application + GH irrigation) and (iv) AB/GHL+ (autogenous bone + GH local application + GH irrigation). Critical-sized defects (diameter = 5.0 mm) were surgically created by a single operator in the calvaria of rats. Defects were filled with ground autogenous bone. Defects pertaining to AB+ and AB/GH+ received a mixture of autogenous bone and a SS-saturated (0.02 mL) collagen sponge covered with bovine cortical membrane. Defects in group AB/GHL+, were filled with the same biomaterials saturated with GH (0.02 mL). SS (0.1 mL) or GH (0.1 mL, equivalent to 0.4 IU) were applied locally on alternate days (8 weeks) in animals in groups AB, AB+ and AB/GH+ or AB/GHL+, respectively. Bone repair properties was determined in hematoxylin/eosin-stained slices using traditional histologic and histomorphometric techniques along with optical microscopy and digital image analysis. Statistical differences among groups was determined using Kruskal-Wallis and Tukey post hoc tests (α = 0.05). Histology results indicated that AB and AB+ displayed greater presence of autogenous bone as compared to AB/GH+ and AB/GHL+. Histomorphometric results indicated significantly higher osteoid matrix formation in AB and AB+ when compared to AB/GHL+ (p = 0.009). Kidneys and livers were found to have their glomeruli preserved in AB and AB+. Strong glomeruli necrosis and large areas of protein deposition were found in AB/GH+. Abnormal small-sized glomeruli were found in AB/GHL+. The utilization of autogenous bone graft associated with local application and irrigation with GH was shown to not improve the bone repair in calvarial critical-sized defects in a rat model., Growth hormone, Rats, Osteogenesis, Wound healing, Materials application, Biomedical materials, Dentistry, Dental materials, Oral medicine

Background Alendronate (ALN) has direct action on bone metabolism, increasing osteogenesis and decreasing bone resorption. The study rated the effect of ALN on femoral fracture repair and the effect of different doses of the drug on the liver and kidneys. Methods Wistar rats were divided into groups: A1 (ALN 1 mg/kg), A2 (ALN 3 mg/kg), and C (saline solution). The drug/solution was applied intraperitoneally three times a week after femoral fracture until euthanasia 45 days later. Results Liver analysis from group A1 presented normal histological aspects, while hepatic steatosis was observed in group A2. In groups A1 and A2, kidneys showed amylocymile like cell degeneration. In femur bone callus, no difference was observed in collagens I and III or in number of trabeculae (p ≥ 0.05). Immunohistochemical evaluation showed positivity for the Transforming Grow Factor β-1 (TGFβ-1) marker in the control group, in spinal area and in small chondrocytes, but negativity for hypertrophy. In A1, an extensive area of cartilaginous expansion was observed, with positive hypertrophic TGFβ-1 cartilage, even in areas with bone matrix. A low positivity was observed in the medullar area, in contrast to the control. Group A2 presented a high number of chondroid matrices and a moderate number of TGFβ-1 cells, with little positivity in medullary area. Conclusions A dosage of ALN 1 mg/kg promotes cellular differentiation activity in the bone callus region, with mild damage in the liver and kidneys. A dosage of ALN 3 mg/kg became toxic without positive alterations in cell differentiation.

Objective To evaluate the effect of a single-dose local administration of PTH on bone healing in rat calvarial bone defects by means of micro-computed tomography, histological and histomorphometric analysis. Design Critical-size cranial osteotomy defects were created in 42 male rats. The animals were randomly divided into 3 groups. In the C Group, the bone defect was only filled with a blood clot. In the S Group, it was filled with a collagen sponge and covered with bovine cortical membrane. In the PTH Group, the defect was filled with a collagen sponge soaked with PTH and covered with bovine cortical membrane. The groups were further split in two for euthanasia 15 and 60 days post-surgery. Data was statistically analyzed with t-tests for independent samples or the nonparametric Mann-Whitney test when applicable. Intragroup comparisons were analyzed with paired t-tests (p Results Micro-CT analysis results did not demonstrate statistically significant intergroup differences. At 15 days post-surgery, the histomorphometric analysis showed that the PTH Group exhibited a significantly higher percentage of bone formation compared with the S Group. At 60 days post-surgery, a higher percentage of new bone was observed in the PTH group. Conclusion The results suggest that the local administration of PTH encouraged the bone healing in critical-size calvarial defects in rats.

The periodontal treatment of teeth with furcation defect is clinically challenging. In cases of class II furcation defects, the regenerative surgery shows low morbidity and good prognosis when correctly indicated. The aim of the present study is to report a treatment option for class II furcation defect through autogenous bone graft associated with the Bichat’s fat pad. Case report: A 59-year-old female patient was diagnosed with class II furcation defect in the left mandibular first molar. The treatment comprised surgical reconstruction of the defect with a combination of maxillary tuberosity bone graft and Bichat’s fat pad. The clinical and radiographic follow-up of 180 days showed bone formation in the furcation area and absence of probing depth. Conclusion: An association of autogenous graft form the maxillary tuberosity with a Bichat’s fat pad proved to be a safe, low cost, and effective therapy for the regenerative treatment of class II furcation.

Gingivitis is still considered a major risk factor for the occurrence and progression of periodontal disease. The aim of the present study was to compare the long-term (1, 12, and 18 weeks) antiplaque and antigingivitis efficacies of two commercially available toothpastes, Colgate Total® (CT) and BlueM® (BM), against attached supragingival dental plaque and gingival inflammation in an experimental gingivitis model. A parallel double-blinded randomized clinical trial including 39 dental students who refrained from all plaque control methods (manual or chemical) for 7 days was conducted. After the establishment of clinical gingivitis, participants were randomized into two experimental groups (CT and BM). Plaque index (PI) and gingival index (GI) were then calculated according to Turesky’s modified Quigley and Hein index. Participants were assessed in four time periods (preclinical trial phase (W −1), gingivitis phase (W0), one week (W1), twelve weeks (W12), and eighteen weeks (W18)). Participants’ stimulated saliva was collected and cultured (either aerobically or anaerobically, 37°C, 48 hours) in each time period (W −1, W0, W1, W12, and W18) for the count of viable colonies. Obtained data were analyzed using 2-way ANOVA and Tukey’s test (α = 0.05). No significant differences were found (p>0.05) between experimental groups at W −1. Significant differences between groups were observed at W0 (p<0.05) for the parameter time period, but not for the interaction between parameters (time period ∗ toothpastes). Lower bacterial counts were observed in both groups after one week of toothbrushing; however, no significant differences were found between investigated dentifrices. Intra- and intergroup comparisons revealed that significant differences were not found (p>0.05) between dentifrices at W1, W12, and W18 for both GI and PI. The present study demonstrated that toothpastes containing active oxygen and lactoferrin (BM) have comparable antiplaque and antigingivitis efficacies with triclosan-containing toothpastes (CT).

The objective of this systematic review was to compare the conical internal connection (IC) with the external hexagonal connection (EH) on the occurrence of marginal bone loss (ΔMBL). Different databases were used to carry out the selection of the elected studies. The studies were judged according to the risk of bias as “high”, “low” and “unclear” risk. For the meta-analysis we included only studies that could extract the data of ΔMBL, survival rate (SR) and probing depth (PD). No statistically significant differences were found for ΔMBL data at one, three- and five-year survival rates between implant connections (p

Gingival recession occurs due to the migration of the gingiva in the apical direction, leading to compromising local aesthetics and root hypersensitivity. Connective tissue graft is the gold standard treatment in these cases improving both functional and aesthetics aspects.The purpose of this case is to report root coverage using the free connective tissue graftingtechnique (CTG) associated with topical application of active oxygen oral gel and mouthwash (blue®m). A 27-year-old female sought care with the main complaint of root hypersensitivity and the presence of gingival recession in the anterior region of the mandible. Clinical examination revealed the presence of type 1 gingival recession in the left mandibular central incisor. The treatment of choice was a modified graft (free connective graft). The graft and recipient bed received applications of blue®m oral gel. The patient was instructed to use blue®m mouthwash and blue®m oral gel after the surgery for 10 days. At 60 days, the patient showed satisfactory healing in the area of the free CTG, with gain of keratinized tissue and partial covering of the gingival recession. Free CTG with the support of the gel and the mouthwash with active oxygen release makes the technique viable, preventing graft necrosis and achieving root coverage and keratinized tissue. La recesión gingival se produce por la migración de la encía en dirección apical, lo que compromete la estética local y la hipersensibilidad radicular. El injerto de tejido conectivo es el tratamiento estándar de oro en estos casos mejorando tanto los aspectos funcionales como estéticos. El propósito de este caso es reportar la cobertura radicular utilizando la técnica de injerto de tejido conectivo libre (CTG) asociada a la aplicación tópica de gel oral de oxígeno activo y enjuague bucal (blue®m). Una mujer de 27 años solicitó atención con el síntoma principal de hipersensibilidad radicular y presencia de recesión gingival en la región anterior de la mandíbula. El examen clínico reveló la presencia de recesión gingival tipo 1 en el incisivo central mandibular izquierdo. El tratamiento de elección fue un injerto modificado (injerto conectivo libre). El injerto y el lecho receptor recibieron aplicaciones de gel oral blue®m. Se le indicó al paciente que usara enjuague bucal blue®m y gel oral blue®m después de la cirugía durante 10 días. A los 60 días, la paciente presentó cicatrización satisfactoria en la zona de la CTG libre, con ganancia de tejido queratinizado y recubrimiento parcial de la recesión gingival. El CTG libre con el apoyo del gel y el enjuague bucal con liberación activa de oxígeno hace viable la técnica, previniendo la necrosis del injerto y consiguiendo cobertura radicular y tejido queratinizado. A recessão gengival ocorre devido à migração da gengiva no sentido apical, levando ao comprometimento da estética local e à hipersensibilidade radicular. Enxerto de tecido conjuntivo é o tratamento padrão ouro nesses casos, melhorando os aspectos funcionais e estéticos. O objetivo deste caso é relatar a cobertura da raiz usando a técnica de enxerto de tecido conjuntivo (CTG) livre associada à aplicação tópica de gel de oxigênio ativo e enxaguatório bucal (blue®m). Uma mulher de 27 anos procurou atendimento com queixa principal de hipersensibilidade radicular e presença de recessão gengival na região anterior da mandíbula. O exame clínico revelou a presença de recessão gengival tipo 1 no incisivo central inferior esquerdo. O tratamento de escolha foi um enxerto modificado (enxerto conjuntivo livre). O enxerto e o leito receptor receberam aplicações de gel oral blue®m. O paciente foi orientado a usar enxaguatório bucal blue®m e gel oral blue®m após a cirurgia por 10 dias. Aos 60 dias, a paciente apresentava cicatrização satisfatória na área do CTG livre, com ganho de tecido queratinizado e cobertura parcial da recessão gengival. A CTG livre com o suporte do gel e o enxaguatório com liberação ativa de oxigênio tornam a técnica viável, evitando a necrose do enxerto, possibilitando o recobrimento radicular com tecido queratinizado.

Introduction: Today, the appreciation of aesthetic dentistry by society brought to the search for materials and techniques that improve the appearance of smile, which is essential in maintaining physical and mental health of the patient. Objective: This study aimed to report a case of gummy smile involving Periodontics and Restorative Dentistry. Case report: This case, despite other possible alternatives, was solved through periodontal surgery (clinical crown augmentation associated with osteotomy) and indirect restorations with porcelain crowns. Conclusion: In our experience this procedure is safe, predictable, with minimal risks or side effects, and it is a treatment option for these cases.

Gingival recession is the most common mucogingival defect, characterized by apical migration of the gingival margin from the cementoenamel junction and root exposure. Several surgical techniques are reported for the treatment of gingival recession. Here we present a comparison of the conventional (coronally advanced flap) and semilunar coronally positioned flap techniques for root coverage in teeth with cervical abrasion restored with pink resin that mimics the color of the gingiva. Although the conventional technique is more predictable, we found that both techniques were effective in achieving satisfactory and esthetic root coverage.

In recent years, there have been a growing number of procedures involving dental implants. Most cases, though, are characterized by bone atrophy, especially horizontal atrophy. This clinical case aims to report a technique for the expansion of the horizontal alveolar ridge. A longitudinal fracture was created in the alveolar ridge to expand the bone, followed by immediate insertion of dental implants along with a particulate allogeneic bone graft. Eight implants were placed in the maxilla, and after 12 months, a surgical reopening was performed, along with rehabilitation with a protocol-type prosthesis, for which a zirconia infrastructure was made. The patient was observed during a 10-month follow-up period in which an effective osseointegration of all implants was achieved as a result of such a technique. The split-crest technique followed by the immediate placement of implants and a particulate allogeneic bone graft proved to be effective, with a predictable osseointegration.

Fresh frozen allograft bone is routinely used in orthopedic surgery for the reconstruction of large bone defects, and its use in oral and maxillofacial surgery is increasing. The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery. This case report presents the insertion of dental implants followed immediately by a placement of fresh frozen allograft in block and particle for a reconstruction of atrophic anterior maxillary in the same surgery. Ten months subsequent to this procedure, provisional fixed prosthesis was installed on the implants. Four months later (postoperative month 14), the final fixed prosthesis was installed and the clinical success was observed. The insertion of dental implants followed immediately by a placement of fresh frozen allograft is a safe and efficient process that results in the successful return of dental function and aesthetic rehabilitation for the patient.

Background: Novel multifunctional biomaterials were recently designed to allow for an optimized tissue regeneration process. Purpose: To comprehensively assess (photographic, radiographic and histological) the in vivo functionality of demineralized bovine bone matrix (DBM) associated with an experimental marine organic extract (MOE) from nacre in a sheep ectopic grafting model. Materials and methods: Synthesis of MOE was based on mixing powdered nacre (0.05 g, particles average size

Purpose: The aim of this randomized clinical trial was to radiographically compare peri-implant marginal bone level changes between immediately loaded implants without the removal of an abutment placed at the time of surgery (IL), delayed loaded nonsubmerged implants (NS), and delayed loaded submerged implants (SI). Materials and Methods: Patients' edentulous sites were randomly allocated to the three groups of implants so that each patient received one implant of each group. Digital periapical radiographs were obtained at baseline as well as three (T1), six (T2), and nine (T3) months after implant insertion. The mesial and distal bone crest levels adjacent to each implant were measured, and the mean values were calculated for each implant at each period. The data were statistically analyzed by repeated measures analysis of variance (ANOVA) and the Tukey test (P < .05). Results: The patient sample comprised 15 subjects (13 women and 2 men; mean age: 47.7 years) with partially edentulous sites in the mandibular posterior area. Forty-five implants were inserted (15 IL implants, 15 NS implants, and 15 SI implants). There was no statistically significant difference between the three groups with regard to changes in the marginal bone level during the follow-up period. The study achieved a 93.3% cumulative survival rate for both delayed loaded groups (NS and IS) and a 100% survival rate for the IL group. Conclusion: In the 9-month period following the implants, no statistically significant differences were found between immediately and delayed loaded implants or between submerged and nonsubmerged implants in bone level changes in patients with partial posterior mandibular edentulism.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious complication of therapy with antiresorptive drugs, such as bisphosphonates (BFs). Although it occurs more often in oncology patients who use intravenous BFs, patients who use oral BFs for osteoporosis are also in the risk group, especially when surgical dental procedures such as dental extraction or dental implants are performed. We report 3 cases of patients who received BF therapy in the past or were still using the medication during dental implant surgery and developed BRONJ and loss of the implants. Prior knowledge by dentists of the adverse effects of BF therapy in patients requiring dental rehabilitation is extremely important in the management of these patients, since BFs may impair the longevity of the dental implant as well as induce osteonecrosis of the jaws, compromising not only oral health but also negatively interfering in the quality of life of these patients.

Autologous bone is reported by scientific literature as the gold standard for the replacement of the bone loss in maxillary atrophic area. Notwithstanding, this grafting type shows several disadvantages as: The procedure morbidity, limited size of the graft and longer recovering time. Recombinant human bone morphogenetic protein type 2 (rhBMP-2) has been used as bone substitute for the reconstruction of large bone defects. The aim of this case was to report a clinical case exhibiting the reconstruction of the atrophic maxilla through using rhBMP-2 as grafting material associated with absorbable collagen sponge (ACS). At 8 months of following-up, osseointegrated implants were placed. After 2 years and 5 months of following-up, it could be observed an appropriate aesthetical and functional rehabilitation.

The containment of the elevator muscle of the upper lip and wing of nose was used for the treatment of patients with gummy smile. This technique had corrected esthetic alterations of smile, reducing the upper lip elevation, which results in a smaller gingival display. An upper lip lengthening as well as a reduction in the upper lip shortening when the patient smiled could be observed. The high smile line was corrected without compromising the labial harmony. This study presents an innovative and effective therapeutic option to obtain a natural and harmonious smile. The patient expressed a high degree of satisfaction.

Introdução: A osteonecrose induzida por medicamentos (ONIM) é uma grave complicação da terapia com drogas antirreabsortivas, como os bifosfonatos (BFs). Embora ocorra com mais frequência em pacientes oncológicos, os quais utilizam BFs endovenosos, pacientes usuários de BFs orais para tratamento de osteoporose também se encontram no grupo de risco, principalmente quando procedimentos odontológicos cirúrgicos como exodontias e implantes dentários são realizados. Objetivo: Relatar três casos de pacientes que fizeram usode BFs no passado ou ainda utilizavam a medicação durante cirurgia para instalação de implantes dentários, abordando os principais fatores de risco para o desenvolvimento da ONIM. Conclusão: O conhecimento prévio pelo implantodontista dos efeitos adversos da terapia com drogas antirreabsortivas em pacientes que necessitam de reabilitação dentária é de extrema importância no manejo desses pacientes, uma vez que elas podem prejudicar a longevidade das reabilitações com implantes e induzir à osteonecrose dos maxilares,comprometendo não somente a saúde bucal como também interferindo negativamente na qualidade de vida dos pacientes.Introduction: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious complication of therapies with anti-resorptive drugs, such as bisphosphonates (BFs). Although it occurs more often in oncology patients who use intravenous BFs, patients who use oral BFs for osteoporosis are also in the risk group, especially when surgical dental procedures such as dental extraction or dental implants are performed. Objective: To report three cases of patients who were submitted to BF therapy in the past or were still using the medication during dental implants surgery and developed BRONJ and lost the implants. Conclusion: It is extremely important that the dentists are aware of the adverse effects of BF therapy in patients that require dental rehabilitation for the management thereof, since they can reduce the longevity of dental implants and induce osteonecrosis of the jaw, compromising not only their oral health but also these patients’ quality of life.

Extensive gingival recessions associated with cervical abrasions are common among the population. Several different surgical and/or restorative therapies have been proposed to correct these lesions. This manuscript reports the treatment of multiple gingival recessions associatedto cervical abrasions. The procedure involved the utilization of subepithelial connective tissue graft (SCTG) combined with coronally advanced flap onto a previously restored root surface. At the postoperative follow-up visits, the success of the restorative/surgical approach was confirmed by the absence of bleeding to probing and periodontal pockets as well as presence of gingival tissue with normal color, texture and contouring. After 18 months of follow-up, the clinical conditions are stable with satisfactory root coverage and periodontal health. An excellent esthetical outcome was achieved and the patient is satisfied with case resolution. (Eur J Dent 2009;3:318-323)

The purpose of this study was to analyze histologically the influence of platelet-rich plasma (PRP) coagulated with two different activators on bone healing in surgically created critical-size defects (CSD) in rat calvaria.Forty-eight rats were divided into three groups: C, PRP-C and PRP-T. An 8 mm diameter CSD was created in the calvarium of each animal. In group C, the defect was filled by a blood clot only. In groups PRP-C and PRP-T, the defect was filled with PRP activated with either calcium chloride or thromboplastin solution, respectively. Each group was divided into two subgroups (n = 8 per subgroup) and killed at either 4 or 12 weeks postoperatively. Histologic and histometric analyses were performed. The amount of new bone formed was calculated as a percentage of the total area of the original defect. Percentage data were transformed into arccosine for statistical analysis (analysis of variance, Tukey's post hoc test, p0.05).No defect completely regenerated with bone. Group PRP-C had a statistically greater amount of bone formation than groups C and PRP-T at both time points of analysis. No statistically significant differences were observed between groups C and PRP-T.It can be concluded that the type of activator used to initiate PRP clot formation influences its biological effect on bone healing in CSD in rat calvaria.

Rehabilitation of edentulous posterior maxilla with implant-supported prostheses frequently presents a challenge to dentists. This is due to insufficient bone within the region, in addition to other limiting factors such as anatomical pneumatization of the maxillary sinus. Thus, grafting of the maxillary sinus is a common procedure used to counteract these problems. Regardless of the type of biomaterial used, the success of the procedure is dependent on the formation of high-quality bone. Therefore, vascularization is a key factor for successful grafting and for the long-term maintenance of the treatment. This paper reports a clinical case of bone graft pneumatization and attempts to elucidate its potential etiology.

The aim of this study was to analyze the transplant efficiency of non-pedicled buccal fat pad graft (BFPG) for the treatment of Miller Class I or II gingival recessions (GRs) and to compare these results with those of subepithelial connective tissue graft (SCTG), which is considered the gold standard. Twelve patients with Miller Class I or II (≥2 mm) bilateral recessions in maxillary premolars or canines were selected. Recessions were randomly assigned to receive SCTG or BFPG. The clinical parameters evaluated at baseline and at 1, 3, and 6 months postoperatively included gingival index, plaque index, probing depth, GR, clinical attachment level, width of keratinized tissue, thickness of keratinized tissue and gingival margin to the acrylic guide. None of the evaluated clinical parameters differed significantly between the groups. At all evaluated postoperative time-points, both groups exhibited statistically significant differences in GR and gingival margin to the acrylic guide compared to baseline. Six months after surgery, the mean percentages of root coverage were 67.5% and 87.5% in the BFPG and SCTG groups respectively. In both groups, complete root coverage was observed in 50% of cases 6 months after surgery. The results presented herein indicate that the use of BFPG transplant has clinical similarities with SCTG and both may be considered as clinically successful methods for treating Miller Class I and II GRs. Resumo O objetivo deste estudo foi analisar a eficiência do transplante do enxerto de tecido adiposo bucal não pediculado (ETAB) para o tratamento de recessões gengivais Classe I e II de Miller e comparar seus resultados com o enxerto de tecido conjuntivo (ETC), que é considerado o enxerto padrão ouro. Foram selecionados 12 pacientes com recessões gengivais bilaterais Classe I e II de Miller presentes em canino ou pré-molares maxilares. As recessões foram randomizadas para receber um dos dois tratamentos ETAB ou ETC. Os parâmetros clínicos avaliados no baseline e com 1, 3 e 6 meses de pós-operatório foram o índice gengival, índice de placa, profundidade de sondagem, recessão gengival (RG), nível clinico de inserção, espessura e largura de tecido queratinizado e a medida da margem gengival ao guia de acrílico (MG-GA). Os resultados mostraram que não houve diferença estatisticamente significativa entre os grupos em nenhum dos parâmetros clínicos avaliados. Os parâmetros clínicos de RG e MG-GA, em ambos os grupos, apresentaram diferença estatisticamente significativa nos 3 períodos pós-operatórios em relação ao baseline. Aos 6 meses de pós-operatório, a média percentual de recobrimento radicular foi de 67,5% e 87,5% para o grupo ETAB e ETC respectivamente. Em ambos os grupos o recobrimento radicular completo foi em 50% dos casos após 6 meses de pós-operatório. Pode-se concluir que o transplante do ETAB apresentou similaridades clínicas com o ETC e ambos os tratamentos podem ser considerados de sucesso clínico para o tratamento de RGs Classe I e II de Miller.

Introduction: The Class I skeletal deformity associated with vertical maxillary excess is a rare condition reported in the literature. Surgical impaction allows the correction of the long face and gummy smile. Objective: This case report aimed to evaluate the positioning of the condyle after Le Fort I osteotomy associated with mandibular selfrotation. Case report: The patient underwent orthognathic surgery for the correction of maxillary vertical excess. Tomography studies were performed to evaluate the initial and final position of the condyle. The patient improved mastication, breathing and phonetics, with esthetic benefit. Conclusion: After the Le Fort I osteotomy and mandibular self-rotation, the condyle remained stable occupying a new anterior-superior position in the glenoid fossa and patient’s TMJremained asymptomatic after 9 months of postoperative follow-up.

Techniques for aesthetic purposes are being frequently used in dental practice due to social context. These techniques can be used to correct concomitant disharmonies in smile. This clinical case aimed to provide a harmonious smile combining the techniques of gingivoplasty and direct veneers on the maxillary anterior teeth. Case report: The gingivoplasty with clinical crown augmentation sought to correct defects present in tooth-gingival anatomy, resulting in arealignment of the gingival contour. Conclusion: The direct veneer technique with composite resins was elected for closing the interincisal diastema and correction the size of the involved teeth, providing a more aesthetic dental anatomy.

The occlusal vertical dimension (OVD) refers to the length of the face as determined by the amount of separation of the jaws. Its determination is important for the manufacture of restorations. However, defining the correct occlusal vertical dimension for edentulous patients is one of the most important steps for function and esthetics rehabilitation. Cephalometry is a standardized method of assessing dental and facial proportions and their interrelation. Additionally, cephalometric analysis of the facial vertical dimension can establish an individual pattern for each patient. This analysis should become a permanent part of each patient’s record. Hence, this study presented a case report with the use of cephalometry as an auxiliary tool in the rehabilitation of OVD. Clinical relevance showed that cephalometric analysis can be an accurate and convenient instrument to treatment planning and prognostic of oral rehabilitation. The reader should understand the clinical implications of using cephalometry as a tool in the rehabilitation of OVD.

This paper describes and discusses the multidisciplinary treatment involving a permanent maxillary lateral incisor fused to a supernumerary tooth, both presenting pulp necrosis and periapical lesion. A 15-year-old male patient sought treatment complaining of pain, swelling and mobility on the maxillary right lateral incisor. After clinical and radiographic examination, root canal preparation was performed according to the crown-down technique and a calcium hydroxide dressing was placed for 15 days. The patient returned and the definitive endodontic filling was done with thermomechanical compaction of gutta-percha and sealer. After 18 months, clinical and radiographic examinations were carried out and no pain or swelling was reported. Two years after endodontic treatment, the patient returned for periodontal and cosmetic treatments. Nine months later, a cone-beam computed tomography (CBCT) revealed that the previously detected periodontal defect and periapical lesion were persistent. Apical endodontic surgery was indicated. The supernumerary tooth was removed, the communicating distal surface was filled and the surgical site received bioactive glass and demineralized bovine organic bone. The pathological tissue was submitted to histopathological examination and the diagnosis was periapical cyst. One year after the apical endodontic surgery, CBCT showed bone formation at maxillary lateral incisor apical area. Two years after the surgery, the restoration was replaced due to aesthetic reasons and periapical radiograph showed success after 5 years of treatment. A correct diagnosis and establishment of an adequate treatment plan resulted in a successful management of the case. Este caso descreve o tratamento multidisciplinar de um incisivo lateral superior permanente fusionado a um dente supranumerário, ambos apresentando necrose pulpar e lesão periapical. Paciente compareceu ao consultório se queixando de dor, edema e mobilidade do incisivo lateral superior. O preparo endodôntico foi realizado no sentido coroa-ápice e foi colocada pasta de hidróxido de cálcio como medicação intra-canal por 15 dias. A seguir, a obturação foi realizada pela termoplastificação da guta-percha. Após 18 meses, foram realizados exames clínicos e radiográficos indicando ausência de dor e edema. Dois anos após o tratamento endodôntico, o paciente retornou para o tratamento periodontal e estético. Nove meses depois, foi realizada tomografia computadorizada e observou-se presença de defeito periodontal e lesão periapical. Foi então indicada e planejada a cirurgia paraendodôntica. O dente supranumerário foi removido e a área de comunicação com o canal radicular do incisivo lateral foi preenchida; a loja cirúrgica foi preenchida com vidro bioativo e osso orgânico bovino desmineralizado. O tecido patológico da lesão periapical foi submetido à análise histopatológica sendo diagnosticado como cisto periapical. Um ano após a cirurgia parendodôntica, uma nova tomografia computadorizada mostrou neoformação óssea na região periapical do dente em questão. Doi anos após a cirurgia, a restauração foi trocada devido à motivos estéticos e uma radiografia periapical mostrou sucesso do tratamento (5 anos após o tratamento inicial). Um correto diagnóstico e plano de tratamento multidisciplinar é essencial para o sucesso do tratamento de dentes fusionados à dentes supranumerários.

We hypothesized that a new technique using nonprocessed adipose tissue could regenerate bone around dental implants. Eighteen rabbits received 1 implant per tibia surrounded by a surgically created osseous defect. The defects were assigned for treatment into 3 groups: C, AT, and AB. The percentages of bone-to-implant contact were 17.64% ± 16.22% (AB), 3.54% ± 7.08% (AT), and 12.71% ± 10.11% (C) (ρ = 0.25). The use of adipose tissue around surgically created peri-implant osseous defects interferes with bone formation.