Introdução: A cirurgia de aumento de coroa clínica com finalidade estética é baseada em parâmetros já descritos na literatura; porém, existe uma dificuldade de organizá-los e, a partir de então, criar um protocolo reprodutível, que torne o procedimento exequível para os cirurgiões-dentistas. Objetivo: Por meio da apresentação de um caso clínico, introduz-se a proposta de utilização de uma tabela, criada com o intuito de compilar tais parâmetros. Resultados: Em um primeiro momento, a tabela pode parecer complexa; todavia, a inserção e a análise correta de dados viabilizam o planejamento de forma clara e precisa. Conclusões: Embora venha sendo utilizada pelos autores há alguns anos, a validação da tabela deverá acontecer a partir do uso de outros profissionais da área.
Review question / Objective: What is the most effective procedure for pain control and surgical wound repair when removing a free gingival graft from the palate? Condition being studied: Different interventions (therapies) have been suggested to minimize postoperative pain and improve the epithelization of the palate following gingival graft harvestings, such as periodontal dressings hemostatic, absorbable gelatin sponges, photobiomodulation, LPRF, hyaluronic acid gel, ozonated oil, electrotherapy treatment, and cyanoacrylate glue. However, there is still limited information on which therapy would be best to minimize postoperative patient discomfort and accelerate wound healing.
This case series reports a modified tunnel technique with connective tissue graft for the root coverage of multiple Miller Class I, II, and III gingival recessions. The modified approach presents an innovative suture technique to improve the stability and position of the graft. Ten patients with multiple gingival recessions (n=85 teeth) received surgical root coverage treatment. The gingival recession height and width were measured and presented as median, minimum, and maximum values. The percentage of the root coverage after at least 12 months expressed the treatment effectiveness. The Shapiro-Wilk test evaluated the normality; pared Wilcoxon test determined the exact P-value for the differences in the height of the gingival recession before and after surgical treatment (α = 0.05). An average of 97.9% (± 5.6%, p < 0.0001) root coverage after treatment occurred, and 73 out of 85 recessions presented complete root coverage after 12 months. Treatment of Miller class I and II gingival recessions resulted in root coverage higher than 99 and class III higher than 95% (p < 0.0001). The presented case series report the efficacy of a modified surgical technique promoting more than 95% of root coverage after 12 months in multiple Miller Class I, II, and III gingival recessions. Well-designed blind randomized controlled trials are needed to validate the proposed technique.
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