Search

The aim is to evaluate the local effect of different concentrations of growth hormone (GH) on the repair of craniofacial bone defects, through histological, histomorfometric, and insulin-like growth factor I (IGF-I) immunoexpression assessments. Critical defects (5 mm) were performed in 32 Wistar rats. The animals were divided into four groups: Group C (Control); Group S (Sponge-collagen); Group GH 0.08 mL; GH 0.104 mg; Group GH 0.1mL. Local applications were performed 3 times a week until the rats were euthanized at 60 days. The data were submitted to ANOVA and Tukey's test (P < 0.05). A healing process with predominance of collagen bers and bone neoformation near the edges of the defect was observed in groups C and S. Islands of bone neoformation were observed at the center and edges of the defect in groups GH 0.08 and GH 0.1. In GH 0.1, the bone was more compact, and the defect was completely closed in some specimens. Bone neoformation was signicantly higher in the GH-treated groups. All the specimens stained positive for IGF-I, and this immunoexpression was signicantly higher in Group GH 0.1. In conclusion, locally applied GH signicantly favored bone repair in rat calvaria, and a higher dose of GH increased the immunoexpression of IGF-I.

The lack of dental papilla in the anterior maxila leaves unsightly smile and the dissatisfied patient. Several surgical techniques can be performed to gain interdental papilla, but few of them are predictable. This case report shows a multidisciplinary treatment alternative to increase disabled papillae in single-tooth implant in an aesthetic region with the use of injectable hyaluronic acid. Monitoring and evaluation of results was made by clinical and photographic monitoring of the progressive increase of the papilla in millimeter measurements through computer software. After 8 applications in 5 months, prosthetic emergence profile of adjacent tooth modification, papillary inflammatory process induction, we can observe 1,0 mm papilla gain. It can be concluded that the use of injectable hyaluronic acid in association with gingival prosthetic conditioning led to increased gingival papilla between tooth and dental implant and can be considered a treatment alternative for correction of minor defects papilla. Keywords: Implant, Aesthetic area, Papilla reconstruction, Hyaluronic acid.

Gum is a portion of periodontal tissue that plays an important role in protecting the surface of the teeth. Its migration beyond the boundaries of the cementum enamel junction, exposing the root of the tooth, is called Gingival Recession (GR) which increases susceptibility to root caries, dentin sensitivity, and aesthetic discomfort. Objective: The main goal of this case report is to describe a surgical procedure that combined the technique of subepithelial connective tissue graft and Plasma-rich fibrin for treatment of gingival recession. Case report: A man, 45 years old, leucoderma, attended the Positive University dental clinic complaining that ‘his gum was rising, and his teeth were sensitive’. Clinical buccal examination was performed according to international guidelines for periodontal data collection and was the man was diagnosed with GR in the region comprising the buccal faces of the first right upper molar to the first right premolar. Before surgical procedure, 60 ml of blood Gum is a portion of periodontal tissue that plays an important role in protecting the surface of the teeth. Its migration beyond the boundaries of the cementum enamel junction, exposing the root of the tooth, is called Gingival Recession (GR) which increases susceptibility to root caries, dentin sensitivity, and aesthetic discomfort. Objective: The main goal of this case report is to describe a surgical procedure that combined the technique of subepithelial connective tissue graft and Plasma-rich fibrin for treatment of gingival recession. Case report: A man, 45 years old, leucoderma, attended the Positive University dental clinic complaining that ‘his gum was rising, and his teeth were sensitive’. Clinical buccal examination was performed according to international guidelines for periodontal data collection and was the man was diagnosed with GR in the region comprising the buccal faces of the first right upper molar to the first right premolar. Before surgical procedure, 60 ml of blood

As lesões pigmentadas na cavidade bucal têm diversas características clínicas, que podem variar desde uma pigmentação fisiológica, como as manchas melânicas, até algo mais grave, como o melanoma maligno. Pela grande diversidade de lesões pigmentadas, os tratamentos são variados e individualizados. Objetivo: Remover manchas melânicas por meio de uma técnica cirúrgica que associa instrumentos rotatórios e lâmina de bisturi. Relato de caso: Paciente de 34 anos, melanoderma, procurou atendimento na Universidade Positivo queixando-se das manchas escurecidas visíveis em sua gengiva e do incômodo que elas lhe causavam por se destacarem ao sorrir. Após o exame clínico, diagnosticou-se presença de pigmentações melânicas. O tratamento proposto foi a remoção cirúrgica das manchas com broca e lâmina de bisturi. No pós-cirúrgico imediato a paciente apresentou boa cicatrização e relatou apenas leve ardência nos três primeiros dias. Após 60 dias, a gengiva se apresentava cicatrizada, sem recidiva das manchas. Conclusão: A técnica escolhida mostrou-se efetiva pois houve cicatrização adequada sem recidiva da pigmentação no acompanhamento pós-operatório.

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.

There are various alternatives for correcting a gingival smile, ranging from techniques such as gingivectomy to more complex and invasive procedures such as orthognathic surgery. Gingival smile is one of the most common complaints of patients seeking an aesthetic smile. This article describes the alternative treatments available for lip repositioning and improving smile aesthetics, and presents the clinical course of a gingival smile patient after undergoing the surgical technique of gingival recontouring (GR) associated with lip repositioning with restorative aesthetic treatment. The surgery performed corrected altered passive eruption of the maxillary anterior teeth and lengthened the lateral beam of the elevator muscle of the upper lip and wing of the nose, and achieved containment with sutures, reducing the gingival smile. After surgery, it was apparent that the high smile line had been successfully corrected without compromising labial harmony. The patient expressed high satisfaction with the treatment. The surgical technique proposed in this study may be a therapeutic option for lip repositioning to achieve smile harmony.

Devido à necessidade da reabilitação com implantes dentários, a cirurgia de levantamento do seio maxilar é descrita como uma técnica segura, neste relato de caso demonstramos uma técnica modificada de levantamento de seio maxilar, a técnica do travesseiro, na qual é confeccionado um travesseiro com uma membrana absorvível preenchida com enxerto ósseo. No momento cirúrgico é utilizada a técnica da janela lateral com deslocamento da membrana de Schneider e inserção do travesseiro. Como resultado clínico foi observado uma quantidade satisfatória de ganho ósseo no pós-operatório de 11 meses. Com essa técnica é possível obter um menor tempo cirúrgico devido à necessidade apenas da preparação do leito receptor, visto que o travesseiro é confeccionado previamente ao ato cirúrgico, além de uma nova manobra para a proteção do biomaterial em casos de perfurações da membrana de Schneider diminuindo a chance de complicações pós-operatórias.

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.

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.

Introduction: Oral pigmentary lesions may have different clinical characteristics, ranging from physiological pigmentation, such as melanin spots, to something more serious, such as malignant melanoma. Due to the great variety of pigmented lesions, the treatments are varied and individualized. Objective: This clinical case reports a case of melanocytic removal through a surgical technique that associates rotary instruments and scalpel blade. Case report: A 45-year-old patient, melanoderma, sought care at the Positivo University, complaining about the dark spots visible on his gum, and the discomfort they caused him when smiling. After the clinical examination, the presence of melanocytic pigmentation was diagnosed and the proposed treatment was surgical removal of spots with a drill and scalpel blade. In the immediate postoperative period, the patient presented good healing and reported only mild burning in the first three days. After 60 days, the gingiva was healed, with no relapsing spots. Conclusion: The technique chosen was effective because it presented adequate healing and absence of relapse of the pigmentation in the postoperative follow-up

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.

Bone graft is a very common procedure that is performed when bone volume needs to be increased before a dental implant. Screws and miniplates are the clinical standards for osteosynthesis. However, some disadvantages for this method have been reported, including artifacts on radiological images, infection, screw loosening, and the need to remove screws that interfere with the dental implants. Bone adhesives are a promising alternative for bone graft surgery.The aim of this study was to compare the shear bond strength of two cyanoacrylate-based adhesives and titanium screws for bone graft fixation.Pig jaw samples were cut into rectangular bars (2 × 6 × 20 mm) and bonded with a 5-mm overlap of N-butyl cyanoacrylate and ethyl cyanoacrylate, and 1.5-mm titanium screws were inserted into the center of the contact area. The blocks were fixed on a shear bond strength device that was coupled to a universal testing machine. The maximum force (N) was recorded on a computer and divided by the bonded area (in mm(2)) in order to calculate the bond strength (MPa). The data were statistically analyzed with ANOVA and Tukey's test (α = 0.05).The shear bond strengths of the screws were significantly higher than both cyanoacrylate adhesives, which presented statistically similar bond strength means, and have the biomechanical potential to be used for bone fixation.Ethyl cyanoacrylate is an inexpensive adhesive that has multiple purposes and can be considered as an alternative for bone fixation.

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 use of dental implants to improve functional and esthetic demands of dentition has increased significantly over the past two decades. Soft and hard tissue management is one of the factors contributing to improved esthetic results. This report describes the correction of an esthetic problem in a single implant combined connective tissue graft and autogenous bone graft. Four months after the surgical procedure, it could be observed that the combination of connective tissue graft and autogenous bone graft resulted in the augmentation of hard and soft tissue in the peri-implant area with favorable esthetic outcomes.

Immunoexpression of PPAR-γ and osteocalcin proteins was evaluated for bone repair of critical-size defects (CSDs), created in rat calvaria (n=42) and treated with fragmented abdominal autogenous adipose tissue graft. Three groups (n=14) were formed: C (control - blood clot), AB (autogenous bone) and AT (fragmented adipose tissue). The groups were divided into subgroups (n=7) for euthanasia at 30 and 90 days. Histological and immunohistochemical analyses were performed. Data were subjected to descriptive statistics (mode). A complete bone closure was observed in Group AB 90 days after surgery. In Group C, repair was achieved by the formation of collagen fiber bundles oriented parallel to the wound surface at both post-surgery periods. In Group AT the type of healing was characterized by dense connective tissue containing collagen fiber bundles arranged amidst the remaining adipose tissue, with rare heterotopic bone formation associated with fibrosis and different types of tissue necrosis. Immunostaining of PPAR-γ was not observed in any specimen from Groups C and AB. In Group AT, the immunostaining of PPAR-γ was more evident 30 days after surgery. Immunostaining of osteocalcin was present in all groups and at both postoperative periods. The fragmented autogenous abdominal adipose tissue graft did not favor the repair of critical-size bone defects created surgically in rat calvaria as evidenced by the positive immunostaining of PPAR-γ protein and the negative immunostaining of osteocalcin in the osteoblast-like cells and bone matrix. A imunoexpressão das proteínas PPAR-γ e osteocalcina foi avaliada para o reparo ósseo de defeitos de tamanho crítico (DTC) criados em calvária de ratos (n = 42) e tratados com enxerto de tecido adiposo autógeno abdominal macerado. Foram formados três grupos (n=14): C (controlo - coágulo de sangue), AB (osso autógeno) e AT (tecido adiposo fragmentado). Estes grupos foram divididos em subgrupos (n = 7) para a eutanásia em 30 e 90 dias. Foram realizadas análises histológicas e imuno-histoquímico. Os dados foram submetidos à análise estatística descritiva (moda). Um fechamento ósseo completo foi observada no grupo AB 90 dias após a cirurgia. No grupo C a reparação foi alcançada através da formação de feixes de fibras de colágeno orientadas paralelamente à superfície da ferida nos dois períodos pós-operatórios. No Grupo AT, o tipo de cicatrização predominante foi caracterizada pela presença de tecido conjuntivo denso contendo feixes de colágeno de fibras dispostas em meio ao tecido adiposo restante, com raras formações ósseas heterotópicas associada à fibrose e diferentes tipos de necrose tecidual. A imunomarcação do PPAR- γ não foi observada em nenhum espécime dos grupos C e AB. No grupo AT a imunomarcação do PPAR-γ foi mais evidente aos 30 dias de pós-operátorio. A imunomarcação da osteocalcina estava presente em todos os grupos e nos dois períodos de pós-operatório O enxerto autógeno abdominal fragmentado tecido adiposo não favoreceu a reparação de defeitos ósseos de tamanho crítico criados cirurgicamente em calvária de ratos como evidenciado pela imunomarcação positiva da proteína PPAR-γ e a imunomarcação negativa de osteocalcina nos osteoblastos e matriz óssea.

The treatment of Miller class III gingival recession is considered a challenge in periodontal practice, and among the different techniques used, autogenous connective tissue graft has shown the most favorable results. In some cases, more than one procedure may be necessary. In this case report, we describe the simultaneous application of a combination of three techniques (the tunnel technique, a connective tissue graft and a laterally positioned flap) to treat a Miller class III gingival recession localized in the lower anterior region. Twelve months after surgical procedures, partial root coverage, favorable esthetic results and a gain in clinical attachment level were observed, with no periodontal pockets or bleeding on probing.