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Master's Dissertation
DOI
10.11606/D.58.2018.tde-20092016-164205
Document
Author
Full name
Gabriel Figueiredo Bastos
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2016
Supervisor
Committee
Novaes Junior, Arthur Belem (President)
Kahn, Sergio
Malheiros, Flavia Adelino Suaid
Menezes, Sílvio Augusto Fernandes de
Title in Portuguese
Comparação clínica entre duas técnicas cirúrgicas para utilização de enxerto de matriz dérmica acelular no tratamento de retrações gengivais múltiplas
Keywords in Portuguese
Estética dental
Estudos comparativos
Matriz dérmica acelular
Recobrimento radicular
Retração gengival
Abstract in Portuguese
O objetivo desse estudo foi comparar duas técnicas cirúrgicas para recobrimento radicular e avaliar qual delas ofereceu o melhor resultado estético e menor morbidade. Foram selecionados 20 participantes adultos, não fumantes, que apresentaram retrações gengivais múltiplas bilaterais, classe I ou II de Miller, localizadas em caninos, primeiros e segundos pré-molares. As duas técnicas utilizaram a MDA como enxerto. Porém, em um quadrante foi realizado um retalho parcial com incisões relaxantes unidas através de uma incisão intrasucular, a MDA foi posicionada a 1 mm apical a junção amelocementária (JAC) e o retalho posicionado a 1 mm coronal a JAC. No quadrante oposto foi realizada uma técnica minimamente invasiva de envelope supra periosteal que não utiliza incisões relaxantes, preserva as papilas, além de evitar eventuais cicatrizes. Os parâmetros clínicos (profundidade clínica de sondagem, nível clínico de inserção, índice de sangramento a sondagem, altura e largura da retração gengival e altura e espessura de gengiva queratinizada) foram avaliados 2 semanas após a terapia periodontal básica e após 6 meses aos procedimentos cirúrgicos. No exame inicial todos os parâmetros foram similares, tanto para grupo teste como para grupo controle. Não houve diferença estatisticamente significante favorecendo nenhuma das técnicas, porém o grupo controle teve números sutilmente melhores do que o grupo teste. Apesar de ambos procedimentos cirúrgicos terem proporcionado melhora significativa em todos os parâmetros analisados, com exceção da PCS, a técnica controle obteve melhores resultados, porém sem diferenças estatisticamente significantes.
Title in English
Comparison between two surgical techniques with acellular dermal matrix for the treatment of multiple recessions: a 6-month randomized clinical trial
Keywords in English
Acellular dermal matrix
Comparison studies
Dental aesthetics
Gingival recession
Root coverage
Abstract in English
Aim: The aim of this study is to compare two surgical techniques using acelular dermal matrix (ADM)for the treatment of gingival recessions. Material and Methods: Twenty patients with bilteral class I and II multiple gingival recession were selected for a Split mouth study design. At one side a modified extended coronally advanced flap (MECAF) was used. At the contralateral a supra periosteal flap (TUN) was performed. Both sides were associated with ADM, so that the technique was the only variable. The clinical parameter evaluated were: probing pocket depth (PD), relative clinical attachment level (RCAL), gingival index (GI), gingival recession height (GR), width of keratinized tissue (KT), keratinized tissu thickness (TKT), and gingival recession area (GRA). Post-operative pain was evaluated with a visual analog scale (VAS) weekly on the first month post operative. Clinical examination was performed at baseline and 6 months post operative. Results: At baseline, no differences at any of the parameters examined could be detected between groups. Both groups were effective to reduce GR, but no difference was detected between them (ΔGR: MECAF= 2.28 ± 1.01; TUN= 1.93 ± 1.36mm). The % of root coverage was numerically superior favoring (MECAF = 61.24 ± 23.42%; TUN= 56.07 ± 22.02%), without significant differences between groups. PD Did not changed significantly after treatment and a clincial attachment gain associated with reduction of gingival recession was noted. Post operative pain was more frequent on MECAF, but no significant difference between groups could be noticed. Conclusions: Both treatments were effective on reducing gingival recession and might be valuable for the treatment of multiple gingival recessions. No significant differences could be shown despite a numerical advantage favored MECAF.
 
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Publishing Date
2018-09-12
 
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