Čimbenici koji utječu na prisutnost papile između susjednih implantata i između zuba i implantataUvod U dentalnoj medicini povećani estetski zahtjevi traže kao ideal konture mekoga tkiva s intaktnim papilama i simetričnim obrisom gingive (1). U idealnom slučaju uspješne implantoprotetičke restauracije izgledaju što je moguće sličnije prirodnim zubima (2). Boja, tekstura, visina i debljina periimplantatnog mekog tkiva najvažniji su u postizanju rezultata s restauracijama na implantatima (3).Uspješna oseointegracija implantata ne jamči zadovoljstvo pacijenata. Za njihovu percepciju uspješne restauracije presudno je zdravlje mekoga tkiva (4). Danas je kod pacijenata koji dolaze radi terapije sve veći naglasak na estetici osmijeha. Prisutnost ili odsutnost interproksimalne papile između susjednih zuba, između zuba i implantata ili između dvaju implantata snažno utječu na estetski ishod, što zahtijeva visoku razinu vještine i stručnog znanja kliničara kako bi očuvao papile u sklopu implantoprotetičke terapije (5 ).Papila je interproksimalni produžetak gingive, a njezina arhitektura povezana je sa stanjem kontaktne točke između Abstract Aim: The aim this study was to evaluate the factors that influence the presence or absence of the interproximal papilla between implants adjacent to the teeth or other implants, through clinical and radiographic evaluation. Material and Methods: The non-probabilistic sample comprised 44 patients of both genders aged between 21 and 68 years, rehabilitated with 114 osseointegrated implants. Through a retrospective clinical study, the patients were divided according to the presence or absence of the interproximal papilla: Group 1 -Absence of Papilla, Group 2 -Partial Presence of Papilla and Group 3 -Total Presence of Papilla. The success of the implants, the periodontal biotype, and the vertical and horizontal distances of the interproximal regions included in the study were evaluated. Results: Of the 114 implants, 46.5% were considered unsuccessful, and bleeding was present in 29.8%. The periodontal biotype presented as thin and scalloped was found in 85.1% of the regions. The evaluation of the groups according to the confirmation of the interproximal space showed a statistically significant difference (p = 0.007), with 61.9% of the wide and long interproximal spaces classified as Group 1, while 31% of the narrow and short interproximal spaces were classified as Group 3. Conclusion: It was concluded that the morphology of the interproximal space was the factor that was most strongly associated with the presence or absence of the interproximal papilla.
Purpose This systematic review aimed to compare the efficacy, defined in terms of the mean percentage of root coverage (mRC), of surgical treatment approaches combined with adhesive restorations of non-carious cervical lesions (NCCLs) to that of root coverage alone in patients with a single gingival recession (GR) and NCCL. Methods A literature search was conducted to identify longitudinal studies reporting the mRC following treatment for the correction of GR defects associated with NCCLs using a combination of surgical and restorative techniques in systemically and periodontally healthy patients. Results The search resulted in the retrieval of 12,409 records. Seven publications met the inclusion criteria for the qualitative synthesis of data. The mRCs ranged from 69% to 97%. In the medium term, the gingival margin position was more stable when a connective tissue graft (CTG) was used, independently of whether restoration of teeth with NCCLs was performed. Conclusions The strength of the evidence was limited by methodological heterogeneity in terms of study design as well as the unit and period of analysis, which precluded a meta-analysis. Although no definitive conclusion could be drawn due to the lack of sufficient evidence to estimate the effectiveness of the interventions, CTG-based procedures contributed to gingival margin stability regardless of the performance of restoration to treat NCCLs.
Objectives:The present study aims to describe the dermabrasion technique to obtain connective tissue rich in collagen, with satisfactory thickness and anatomy, removing the epithelial layer with diamond drill in high speed handpiece and under refrigeration. Materials and Methods:A 50-year-old patient was selected for immediate dental implant (element 25) and soft tissue augmentation in the periodontal and peri-implant region. An epithelial connective tissue graft was performed in the area comprising elements 23, 24, 25 and mesial of 26. For the preparation of the donor area of the graft, the dermabrasion technique was used through a spherical diamond drill bit (medium or thick granulation) in high speed and under refrigeration, being able to remove the epithelium without losing part of the subepithelial layer. Results:The healing process is by second intention and presented a normal evolution with formation of adequate tissues. Conclusions:The Dermabrasion technique allows to obtain adequate grafts, removing the epithelial layer in a simple way and guarantee the desired thickness.
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