Achieving root coverage after exposure caused by gingival recession is one of the main goals of reconstructive periodontal surgery. Even though a large variety of techniques and mucogingival grafting procedures are available, their long-term results are not clear yet. Therefore, this study aimed to compare clinical effectiveness of the porcine collagen matrix with subepithelial connective graft for treating Miller class I and II gingival recessions. Materials and methods: The randomized clinical trial included twelve patients assigned to two groups. In the first group (experimental), six patients were treated using collagen matrix (mean age, 54.3 ± 5.6 years; mean recession 2. 67 ± 1.03 mm). Another group (control) of six patients was treated using connective grafts (mean age, 57.1 ± 2.7 years; mean recession 4.33 ± 1.03 mm). All patients underwent periodontal evaluation and pre-surgical preparation including oral hygiene instruction and supragingival scaling. Gingival recessions were exposed through partial thickness flaps where the grafts and matrices were placed. Patients were assessed periodically until complete healing of tissue. Results: Root coverage parameters, amount of keratinized gingiva, gingival biotype and clinical attachment level were evaluated. The root coverage percentage for the group using connective graft was 24.7 ± 13.5 % and 16.6 ± 26.8 % for the one treated with the matrix. The amount of increased keratinized tissue was 4.33 ± 2.06 mm and 4.5 ± 0.83 mm for the control and experimental group respectively. Both groups increased gingival biotypes from thin to thick at 100%. The final clinical attachment level was 4.17 ± 3.17 ± 04mm for the control group and 0.98 mm for the experimental group. There were significant differences between the outcome of gingival recession and clinical attachment. Conclusion: Results indicate both techniques, besides being predictable, are useful for improving clinical parameters when treating gingival recessions. Regardless of the fact that better root coverage was obtained with the subepithelial connective graft, both methods are really useful for increasing the thickness of keratinized tissue. Keywords: Gingival recession, connective tissue, grafts, periodontal disease, collagen matrix.Matriz de colágeno de origen porcino en el tratamiento de las recesiones gingivales. Ensayo clínico aleatorio.Resumen: Lograr la cobertura radicular que se expone por las recesiones gingivales es uno de los principales objetivos de las cirugías periodontales reconstructivas. Una gran variedad de técnicas e injertos mucogingivales se encuentran como opciones terapéuticas. Sin embargo, los resultados y efectividad a largo plazo aún no son claros. Este estudio tuvo como objetivo comparar la efectividad clínica de la matriz de colágeno de origen porcino versus el injerto conectivo subepitelial en el tratamiento de las recesiones gingivales Miller clase I y II. Materiales y métodos: Ensayo clínico aleatorizado donde participaron 12 pacientes asignados de manera aleatoria en...
REVIEWFactores de riesgo y periimplantitis en la terapia implantológica. Revisión narrativa.Bravo F, Castro Y & Grados S. Factores de riesgo y periimplantitis en la terapia implantológica. Revisión narrativa. J Oral Res 2013; 2(3): 139-144.Resumen: Las enfermedades que involucran a los tejidos que rodean a los dientes y a los implantes osteointegrados son el resultado de una interacción entre algún tipo de agente patológico (bacteriano, viral, etc.) y la respuesta inmunitaria del huésped. Estas interacciones se pueden dar tanto en los tejidos dentarios como en aquellos biomateriales que se introducen para tratar de corregir algún tipo de patología periodontal; los implantes al ser sustitutos biocompatibles de las piezas dentarias no están exentas de este tipo de interacciones que muchas veces cursan con patologías periodontales y periimplantarias. La periimplantitis es un tipo de patología que resulta de dicha interacción; los factores de riesgo e indicadores de riesgo de la periimplantitis son amplios y complejos. El presente artículo resume las múltiples fuentes de información de la literatura científica para abordar al detalle los aspectos de los principales factores de riesgo y la periimplantitis en la terapia implantológica.. Palabras clave: Implantes dentales, mucosa periimplantaria, periodontitis crónica, factores de riesgo.Risk factors and periimplantitis in implant therapy. Narrative review.Abstract: Diseases involving tissue around the teeth and osseointegrated implants are the result of an interaction between some type of pathological agent (bacterial, viral, etc.) and host immune response. These interactions can occur both in the dental tissues as those biomaterials which are introduced to attempt to correct some type of periodontal disease, the implant being a biocompatible substitute of the teeth is not free from this type of interaction often enrolled periodontal and peri-implant pathology. The peri-implantitis is a type of disease that results from this interaction, the risk factors and risk indicators of peri-implantitis are broad and complex. This article summarizes the multiple sources of information in the scientific literature to address in detail the aspects of the main risk factors and the peri-implantitis in the peri implant therapy.
Abstract:A good amount and width of keratinized tissue around implants has been associated with better peri-implant health, less bone loss and improved esthetics. The purpose of this case was to evaluate a new porcine xenograft (collagen matrix) used as an interpositional graft to augment thickness of the peri-implant mucosa. There are few studies using a collagen matrix as a substitute for subepithelial connective graft around implants. This case involved a clinical implant in teeth 15 in which it was made the most of it during placement of healing abutment by taking the opportunity to increase periimplant mucosa with a collagen matrix. Thickness increased 1.5mm while the amount of keratinized mucosa was kept at 4mm. It is concluded that the collagen matrix of porcine origin is a good alternative to increase thickness of the peri-implant mucosa and reduce morbidity. It is easy to handle and suture as well.
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