Sérgio Kahn

Clinical Considerations on the Root Coverage of Gingival Recessions in Thin or Thick Biotype.

Gingival biotype is a clinical term used to describe the thickness of the gingiva. It has been classified as being thick or thin and may be related to the clinical outcome of root coverage procedures. This study evaluated the impact of gingival biotype on the clinical outcome of root coverage procedures following subepithelial connective tissue graft plus coronally positioned flap. A total of 19 patients, 10 with thin and 9 with thick gingival biotype, were treated for localized Miller Class I or II gingival recessions. After 6 months, 14 patients achieved complete root coverage, 7 from each group. The overall mean pooled root coverage rate was 90.93%. The thin biotype cases yielded a reduced mean root coverage of 88.51% compared with 93.63% for patients who had the thick biotype classification. Although the thin gingival biotype may impair the clinical outcome of root coverage procedures, this limitation does not appear to have a strong influence on the success of the root coverage therapy when subepithelial connective tissue graft was associated with the coronal positioning of the flap.

Periodontal Plastic Microsurgery in the Treatment of Deep Gingival Recession after Orthodontic Movement

Gingival recession is a condition that affects a large portion of the young and adult population and negatively affects the aesthetic aspects of the smile. Many factors are related to its development, including orthodontic movement beyond the osseous limits. Many treatment options have been proposed to cover the exposed root surface. The aim of this article was to describe three cases where a subepithelial connective tissue graft was performed, using a microsurgical technique, in the treatment of deep gingival recession after orthodontic treatment. This technique resulted in successful root coverage and keratinized tissue gain, improving the gingival esthetic pattern.

Effects of non-surgical periodontal treatment on complete blood count, lipid and glycemic profiles of patients with an indication for surgical coronary revascularization

Objective: the aim of this study was to assess the effects of non-surgical periodontal treatment on the complete blood count, glycemic and lipid profiles in cardiopathic patients with indication for surgical revascularization. Material and Methods: this study evaluated 22 patients with chronic periodontitis, over 35 years of age (mean age 59.45 years) randomly assigned to 2 groups. The test group (n=11) received periodontal treatment before the surgical procedure and the control group (n=11) did not receive periodontal treatment prior to surgery. Results: periodontal treatment resulted in a significant reduction in probing depth in sites with periodontal probing depth >3 mm (reduction of 11.4%) and >5 mm (reduction of 6.3%) (P 0.05). The values regarding to leukocyte count, glucose, hemocyte and hemoglobin did not differ significantly between groups (P>0.05). Total cholesterol and high density lipoprotein presented a statistically significant reduction in the test group (P 0.05). Conclusion: non-surgical periodontal treatment was effective for controlling periodontal disease and diminished serum levels of total cholesterol and high density lipoproteins. The other blood components presented no significant alterations.

Prevalence of dehiscences and fenestrations in human cadavers

Objective: the aim of the present study was to evaluate the prevalence of dehiscences and fenestrations in a convenience sample of human cadavers to provide accurate identification of bone defects. Material and Methods: twenty human cadavers, ranging in age from 20 to 40 years, were evaluated for dehiscences and fenestrations, which were verified after mucoperiosteal flap elevation. Results: the prevalence of dehiscences and fenestrations in the specimens was confirmed as being 40%, accounting for 5% of teeth with lesions. The most prevalent lesions were dehiscences, while only one single case of maxillary fenestration was observed. Conclusion: the planning of any periodontal plastic surgeries performed in the anterior region must take into account the possibility of periodontal defects. Therefore, considering the high prevalence of bone defects with potential impact in the esthetic outcome, the manipulation of soft tissues should be done carefully, especially in patients with a thin periodontium.

Enxerto de tecido conjuntivo subepitelial associado à recessão gengival em pilares de prótese parcial fixa: relato de caso clínico

Periodontal plastic surgery procedures aim the correct of mucogingival defects, among which, gingival recession. This case involves the use of subepithelial connective tissue graft in the treatment of Miller Class III gingival recession in a dental pillar element of a fixed partial prosthesis. A partial thickness flap associated to two vertical incisions was made. An subepithelial connective tissue graft taken from the palate was placed over the root surface. The flap was coronally positioned so as to cover the graft entirely. Six months after the treatment, complete root coverage of the dental element could be observed. This clinical study show how the grafting of supepithelial connective tissue can be successfully used in root coverage of a dental pillar element of a partial fixed prosthesis with Miller Class III gingival recession.