Abstract Objective To determine whether intra-mucosal injection of injectable platelet-rich fibrin (i-PRF) can promote healing after Diode Laser Gingival Depigmentation (DLGD). Methodology A total of 20 arch sites of hyperpigmented gingiva of 10 patients underwent DLGD. For each patient, two arch sites were randomly assigned for either intra-mucosal injection of i-PRF (G1-i-PRF) (n=10 sites) or no treatment (G2-Control): (n=10 sites). Wound Healing Score (WHS), patient satisfaction, and Pigmentation Index (DOPI) were measured at 1 week and 1 and 3 months postoperatively. Histological assessment of tissue specimens was performed at baseline and 1 week. Results The percentage change in WHS at 1 week was significantly higher in G1 (58.34±15.43) compared to G2 (37.50±11.79). At day 1, 50% of patients in G1 were pain free compared with 75% in G2, who had mild pain. Mean DOPI decreased significantly at 3 months in both groups (P-value <0.001), without significant differences between groups. G1 specimens showed significantly higher epithelial thickness (P-value <0.001), as well as a higher number of blood vessels and less percentage of inflammatory cells. Conclusions i-PRF demonstrated better clinical and histological healing potential and less patient discomfort compared to sites without treatment after DLGD. Registered at https://clinicaltrials.gov/ as (NCT05283668). intramucosal intra mucosal plateletrich platelet rich iPRF i PRF (i-PRF DLGD . (DLGD) 2 G1iPRF GiPRF G (G1-i-PRF n=10 n10 n (n=1 G2Control GControl Control (G2-Control) sites. WHS, , (WHS) satisfaction (DOPI postoperatively 58.34±15.43 58341543 58 34 15 43 (58.34±15.43 37.50±11.79. 37501179 37.50±11.79 37 50 11 79 (37.50±11.79) 75 Pvalue P value <0.001, 0001 <0.001 0 001 <0.001) cells https//clinicaltrials.gov/ httpsclinicaltrialsgov https //clinicaltrials.gov/ clinicaltrials gov https://clinicaltrials.gov NCT05283668. NCT05283668 NCT (NCT05283668) (DLGD n=1 n1 (n= (G2-Control (WHS 58.34±15.4 5834154 5 4 (58.34±15.4 3750117 37.50±11.7 7 (37.50±11.79 000 <0.00 00 https//clinicaltrials.gov clinicaltrialsgov //clinicaltrials.gov NCT0528366 (NCT05283668 n= (n 58.34±15. 583415 (58.34±15. 375011 37.50±11. (37.50±11.7 <0.0 NCT052836 (NCT0528366 58.34±15 58341 (58.34±15 37501 37.50±11 (37.50±11. <0. NCT05283 (NCT052836 58.34±1 5834 (58.34±1 3750 37.50±1 (37.50±11 <0 NCT0528 (NCT05283 58.34± 583 (58.34± 375 37.50± (37.50±1 < NCT052 (NCT0528 58.34 (58.34 37.50 (37.50± NCT05 (NCT052 58.3 (58.3 37.5 (37.50 NCT0 (NCT05 58. (58. 37. (37.5 (NCT0 (58 (37. (NCT (5 (37 ( (3

Abstract Objective This study aimed to validate the integrated correlation between the buccal bone and gingival thickness of the anterior maxilla, and to gain insight into the reference plane selection when measuring these two tissues before treatment with implants. Methodology Cone beam computed tomography (CBCT) and model scans of 350 human subjects were registered in the coDiagnostiX software to obtain sagittal maxillary incisor sections. The buccal bone thickness was measured at the coronal (2, 4, and 6 mm apical to the cementoenamel junction [CEJ]) and apical (0, 2, and 4 mm coronal to the apex plane) regions. The buccal gingival thickness was measured at the supra-CEJ (0, 1mm coronal to the CEJ) and sub-CEJ regions (1, 2, 4, and 6 mm apical to the CEJ). Canonical correlation analysis was performed for intergroup correlation analysis and investigation of key parameters. Results The mean thicknesses of the buccal bone and gingiva at different levels were 0.64~1.88 mm and 0.66~1.37 mm, respectively. There was a strong intergroup canonical correlation between the thickness of the buccal bone and that of the gingiva (r=0.837). The thickness of the buccal bone and gingiva at 2 mm apical to the CEJ are the most important indices with the highest canonical correlation coefficient and loadings. The most and least prevalent subgroups were the thin bone and thick gingiva group (accounting for 47.6%) and the thick bone and thick gingiva group (accounting for 8.6%). Conclusion Within the limitations of this retrospective study, the thickness of the buccal bone is significantly correlated with that of the buccal gingiva, and the 2 mm region apical to the CEJ is a vital plane for quantifying the thickness of these two tissues maxilla implants CBCT (CBCT 35 sections (2 [CEJ] 0, 0 (0 supraCEJ supra subCEJ sub 1, 1 (1 CEJ. . parameters 064188 64 88 0.64~1.8 066137 66 37 0.66~1.3 respectively r=0.837. r0837 r r=0.837 837 (r=0.837) loadings accounting 47.6% 476 47 8.6%. 86 8.6% 8 8.6%) 3 ( [CEJ 06418 0.64~1. 06613 0.66~1. r083 r=0.83 83 (r=0.837 47.6 8.6 0641 0.64~1 0661 0.66~1 r08 r=0.8 (r=0.83 47. 8. 064 0.64~ 066 0.66~ r0 r=0. (r=0.8 06 0.64 0.66 r=0 (r=0. 0.6 r= (r=0 0. (r= (r

Abstract: This study aimed to compare the use of connective tissue grafts (CTG) and platelet-rich fibrin (PRF) associated with the tunnel technique (TT) for the treatment of multiple gingival recessions (GR). Fourteen patients with multiple bilateral GR [type 1 recession (RT 1)] in the maxillary incisors, canines, and/or premolars were included. The TT was performed on both sides (split-mouth model); CTG (36 GR) was used on one side, and on the other, PRF (36 GR) was used. Clinical parameters, including recession depth (RD), probing depth, clinical attachment level (CAL), and keratinized gingiva thickness/width (GT/KTW), were obtained at baseline and after 1, 3, 6, and 16 months. Lower RD (0.81 ± 0.68 vs. 1.23 ± 0.71 mm) and CAL (2.54 ± 0.63 vs. 2.73 ± 0.82 mm) were observed for CTG compared to PRF after 16 months. Higher GT was obtained for CTG compared to PRF after 3 (1.81 ± 0.56 vs 1.43 ± 0.47 mm) and 6 months (1.67 ± 0.61 vs. 1.38 ± 0.55 mm, p < 0.05). The recession coverage (RC) was higher for CTG (55.42% ± 37.14) in comparison to PRF (29.53% ± 34.08) after 16 months (p < 0.05). Similarly, CTG presented a more complete coverage of the recession (15; 41.66%) than PRF (9; 24.32%). There were no significant differences between the groups in terms of surgery time, postoperative pain, or healing patterns. Greater esthetic satisfaction was obtained with CTG. It was concluded that CTG combined with TT showed clinical and esthetic results superior to those of PRF in multiple GR treatments. Abstract (CTG plateletrich platelet rich (PRF (TT GR. . (GR) type RT 1) incisors canines andor included splitmouth split mouth model model) 36 (3 side other parameters RD, , (RD) CAL, (CAL) thicknesswidth thickness width GT/KTW, GTKTW GT/KTW KTW (GT/KTW) 0.81 081 0 81 (0.8 068 68 0.6 123 23 1.2 071 71 0.7 mm 2.54 254 2 54 (2.5 063 63 273 73 2.7 082 82 0.8 1.81 181 (1.8 056 56 0.5 143 43 1.4 047 47 0.4 1.67 167 67 (1.6 061 61 138 38 1.3 055 55 0.05. 005 0.05 05 0.05) RC (RC 55.42% 5542 42 (55.42 37.14 3714 37 14 29.53% 2953 29 53 (29.53 34.08 3408 34 08 Similarly 15 (15 41.66% 4166 41 66 9 (9 24.32%. 2432 24.32% 24 32 24.32%) time pain patterns treatments (GR ( (RD (CAL (GT/KTW 8 (0. 06 0. 12 1. 07 7 2.5 25 5 (2. 27 2. 1.8 18 (1. 4 04 1.6 13 00 0.0 55.42 554 (55.4 37.1 371 29.53 295 (29.5 34.0 340 (1 41.66 416 243 24.32 (0 (2 55.4 (55. 37. 29.5 (29. 34. 41.6 24.3 55. (55 29. (29 41. 24. (5

ABSTRACT The gingival cyst of the adult (GCA) is a rare odontogenic cyst, consisting of 0.3% of all odontogenic cysts. This case report, based on CARE guidelines for case reports, aims to present a case of a 52-year-old female patient with a symptomatic translucent nodule in the upper left anterior gingiva, measuring approximately 6mm. Excisional biopsy was performed, and the histological examination revealed multiple cystic cavities lined by the squamous epithelium of varying thickness with focal areas of nodular thickenings. The presence of clusters of cells with clear cytoplasm within epithelial thickenings was observed. PAS staining was negative in clear cells. The diagnosis of the GCA was established. Despite its rarity, GCA should be considered in the differential diagnosis of gingival lesions. Conservative surgical treatment proved to be effective, with no signs of recurrence. (GCA 03 0 3 0.3 cysts report reports 52yearold yearold 52 year old gingiva 6mm mm performed observed established rarity lesions effective recurrence 0. 5

RESUMO Objetivo: O presente estudo teve como objetivo investigar a relação entre a inclinação dentária e as dimensões ósseas e gengivais em dentes anteriores superiores. Métodos: Esse estudo transversal incluiu imagens de tomografia computadorizada de feixe cônico (TCFC) de 160 dentes anteriores superiores divididos em três grupos (incisivo central, incisivo lateral e canino). Todos os pacientes tinham 18 anos ou mais, não tinham tratamento ortodôntico prévio nem história clínica que pudesse afetar as dimensões ósseas ou gengivais. A inclinação dentária, a espessura do osso e da gengiva e as distâncias da junção cemento-esmalte à crista óssea alveolar e à margem gengival foram medidas na face vestibular. As correlações foram analisadas por meio dos testes de Pearson e de correlação parcial (p≤0,05). Resultados: Nos incisivos centrais, a inclinação dentária foi positiva e significativamente relacionada à espessura do osso apical (R = 0,34, p= 0,001). Nos caninos, a inclinação dentária foi negativa e significativamente relacionada à espessura do osso cervical (R = - 0,34, p= 0,01) e positivamente associada à espessura do osso apical (R = 0,36, p= 0,01) e à distância entre a margem gengival e a junção cemento-esmalte (R = 0,31, p= 0,03). Nos incisivos laterais, a inclinação do dente não foi associada às dimensões do osso ou da gengiva. Conclusões: Nos incisivos centrais, quanto maior a inclinação vestibular do dente, maior a espessura do osso apical. Nos caninos, quanto maior a inclinação vestibular do dente, menor a espessura do osso cervical, maior a espessura do osso apical e maior a margem gengival. As dimensões ósseas e gengivais devem ser avaliadas ao se planejar o tratamento ortodôntico envolvendo a movimentação vestibular dos incisivos centrais e caninos.

ABSTRACT Objective: The present study aimed to investigate the relationship between tooth inclination and gingival and bone dimensions in maxillary anterior teeth. Methods: This cross-sectional study included cone-beam computed tomography (CBCT) images of 160 maxillary anterior teeth (30 individuals). Tooth inclination, gingival and bone thickness, and distances from cementoenamel junction to alveolar bone crest and gingival margin were measured in the labial surface. The correlations were analyzed using Pearson and partial correlation tests (p≤0.05). Results: In the central incisors, tooth inclination was positively and significantly related to apical bone thickness (R = 0.34, p= 0.001). In the canines, tooth inclination was negatively and significantly related to cervical bone thickness (R = - 0.34, p= 0.01) and positively associated to apical bone thickness (R = 0.36, p= 0.01) and to gingival margin-cementoenamel junction distance (R = 0.31, p= 0.03). In the lateral incisors, tooth inclination was not associated with gingival or bone dimensions. Conclusions: In the central incisors, the greater the labial tooth inclination, the greater is the apical bone thickness. In the canines, the greater the labial tooth inclination, the smallest is the cervical bone thickness, the greater is the apical bone thickness, and the greater is the gingival margin. Gingival and bone dimensions should be assessed when planning orthodontic treatment involving buccal movement of central incisors and canines.

Aim This study aims to evaluate the clinical assessment results of periimplant soft tissue with morse taper (internal abutment connection). Methods The study was conducted using a rapid review by searching the articles from PubMed NCBI and Cochrane by using keywords. All articles were selected by the year, duplication, title, abstract, full-text, and finally, all selected articles were processed for final review. Following clinical parameters were included; Periimplant Probing Pocket Depth (PPD), Plaque Score (PS), modified Plaque Index (mPI), Mucosal Thickness (MTh), Gingival Height (GH), periimplant mucosal zenith, Pink Esthetic Score (PES), Bleeding On Probing (BOP), Sulcus Bleeding Index (SBI), and modified Gingival Index (mGI). Results 9 selected articles were obtained from the initial literature searching count of 70 articles. The overall samples included 326 morse taper implants. Based on the evaluation, 3 out of 4 articles reported pocket depth < 4 mm, no bleeding was reported in 2 out of 4 articles. 4 out of 4 articles reported low plaque accumulation, low soft tissue recession was reported in 3 out of 3 articles, and 4 out of 4 articles reported acceptable PES values. Conclusion The evaluations indicate that the morse taper (internal abutment connection) has favorable assessment results based on various clinical parameters.

ABSTRACT Introduction: Keratinized gingiva is an important component of the mucogingival complex. Its absence may be due to gingival recessions, trauma, root caries, among others. The free gingival graft technique is considered the gold standard, as it is an optimal technique to increase the extension of the vestibule and the width of the keratinized tissue due to its high success rates and clinical predictability. Objective: The purpose of this clinical case was to evaluate the use of a modification of the free gingival graft technique. Case report: The clinical case included an increase in the depth of the vestibule as well as the keratinized gingiva in both areas of the anteroinferior sector, for which the two hemiarchates of the palate were used as the graft donor area (double graft). The case used a free double gingival graft as a novel technique for gingival augmentation. After two months of healing, a reduction in the gingival recession was observed, as well as a noticeable increase in the width of the keratinized gingiva. Conclusions: The modified free double gingival graft technique is a good alternative to increase the thickness of the keratinized gingiva in the anteroinferior sector, in addition to reducing the post-operative time and generating uniform healing at the level of the mucogingival line.

RESUMEN Introducción: La encía queratinizada es un componente importante del complejo mucogingival. Su ausencia puede deberse a recesiones gingivales, traumas, caries radicular, entre otras. La técnica de injerto gingival libre es considerada el estándar de oro, por ser una técnica óptima para aumentar la extensión del vestíbulo y el ancho del tejido queratinizado por sus altas tasas de éxito y predictibilidad clínica. Objetivo: El propósito de este caso clínico fue evaluar el uso de una modificación de la técnica del injerto gingival libre. Presentación de caso: El caso clínico incluyó aumento de la profundidad del vestíbulo y de la encía queratinizada en ambas zonas del sector anteroinferior, para lo cual se utilizaron las dos hemiarcadas del paladar como la zona dadora del injerto (doble injerto). El caso utilizó un doble injerto gingival libre como técnica novedosa para el aumento gingival. Después de dos meses de cicatrización, se observó reducción de la recesión gingival y un aumento notorio del ancho de la encía queratinizada. Conclusiones: La técnica modificada de doble injerto gingival libre, es una buena alternativa para aumentar el grosor de la encía queratinizada en el sector anteroinferior, además de reducir el tiempo posoperatorio y generar una cicatrización uniforme a nivel de la línea mucogingival.

Resumo Introdução A determinação do fenótipo gengival possibilita compreender melhor as variações e diferenças clínicas intra e interindividuais dos tecidos periodontais saudáveis. Objetivo O objetivo deste estudo foi determinar os perfis do fenótipo gengival e compará-los em diferentes regiões da cavidade oral, levando em consideração parâmetros clínicos relacionados aos tecidos moles circunjacentes nos dentes anteriores superiores e inferiores. Material e método Noventa e um pacientes com saúde periodontal foram examinados e os parâmetros clínicos profundidade de sondagem (PS), largura de mucosa ceratinizada (MC), espessura gengival em ambos incisivos centrais superiores (EG) e fenótipo gengival (FG) foram coletados nos dentes anteriores superiores e inferiores. Os dados foram analisados estatisticamente pelos testes t-Student pareado e independente, Correlação de Pearson e Qui-quadrado, com um nível de significância de 5%. Resultado O fenótipo gengival espesso predominou nos dentes anteriores superiores (60,5%), enquanto o fenótipo fino foi mais prevalente nos dentes anteriores inferiores (84,6%). Diferenças estatisticamente significativas foram encontradas para os parâmetros largura de mucosa ceratinizada e espessura gengival em relação aos fenótipos gengivais superiores e inferiores (p<0,05). Não houve diferença estatística entre profundidade de sondagem e o fenótipo gengival nos dentes superiores e inferiores. Conclusão Concluiu-se que o fenótipo gengival espesso é mais frequente nos dentes anteriores superiores e que o fenótipo fino é mais comum nos dentes anteriores inferiores, sendo mais frequente em indivíduos do sexo masculino. Os parâmetros largura de mucosa ceratinizada e espessura gengival mostraram-se adequados à determinação do fenótipo gengival.

Abstract Introduction Gingival phenotype determination enables a better understanding of intra and interindividual clinical variations in healthy periodontal tissues. Objective The aim of this study was to determine gingival phenotype profiles and compare these in different regions of the oral cavity, considering clinical parameters related to the surrounding soft tissue in the upper and lower front teeth. Material and method Ninety-one periodontally-healthy patients were examined and clinical parameters such as probing depth (PD), keratinized tissue width (KW), gingival thickness at both maxillary central incisors (GT) and gingival phenotype (GP) were determined for the upper and lower front teeth. Data were statistically analyzed by paired and independent t-Student tests, Pearson Correlation and the Chi-square test, using a significance level of 5%. Result The thick gingival phenotype predominated in the upper anterior teeth (60.5%), while the thin phenotype was more prevalent in the lower anterior teeth (84.6%). Statistically significant differences were found for keratinized tissue and gingival thickness parameters, in relation to the upper and lower gingival phenotypes (p<0.05). There were no statistical significances for probing depth and gingival phenotype in the upper and lower teeth. Conclusion It was concluded that the thick phenotype is more frequent in the upper anterior teeth and that the thin phenotype is more common in the lower anterior teeth, and more frequent in males. The keratinized tissue and gingival thickness parameters proved to be suitable for the determination of gingival phenotype.

Resumo Objetivo Avaliar o comportamento do tecido gengival após a instalação de implantes imediatos em função imediata, por meio de (1) medidas clínicas diretas de altura e espessura da margem de tecido mole peri-implantar, (2) medidas de altura gengival em fotografias, e (3) percepção de profissionais da área de odontologia em relação a parâmetros estéticos. Material e método O estudo incluiu 8 pacientes com incisivo central ou lateral indicados para extração. Medidas diretas de altura e espessura da margem de tecido mole peri-implantar foram realizadas imediatamente antes da extração (T0) e 1 (T1), 4 (T2), 8 (T3) e 12 (T4) meses após a instalação de implante sem abertura de retalho. Fotografias foram tiradas nos mesmos tempos. Um questionário foi respondido por Implantodontistas em relação à percepção visual dos mesmos sobre coloração, arquitetura da margem de tecido mole peri-implantar e harmonia na região do implante usando fotografias obtidas no T4. Resultado Os resultados clínicos mostraram alterações significantes na altura da margem de tecido mole peri-implantar, mas nas fotografias não foi observada diferença estatisticamente significante para essa mesma medida. A espessura da gengiva inserida se manteve durante todo o período de observação. Dos profissionais entrevistados, 35,2% observaram coloração alterada na região do implante, 39,8% identificaram alteração na arquitetura da margem de tecido mole peri-implantar e 12,5% alteração na harmonia da margem de tecido mole peri-implantar. Conclusão Os tecidos moles ao redor de implantes imediatos sofreram alterações durante o período estudado, mas não afetaram o resultado estético e na opinião dos profissionais os resultados foram satisfatórios.

Abstract Objective To assess the behavior of the peri-implant soft margin after immediate implant placement with immediate function, by (1) direct clinical measurements of peri-implant soft margin height and thickness, (2) measurements of peri-implant soft margin height on photographs and (3) the perception of dental professionals regarding the results considering esthetic parameters. Material and method The study included 8 patients with central or lateral incisors indicated to be extracted. Direct measurements of peri-implant soft margin height and thickness were done immediately before extraction (T0) and 1 (T1), 4 (T2), 8 (T3) and 12 (T4) months after the flapless insertion of the implant. Photographs were taken at the same time intervals. A questionnaire was filled in by implantology professionals regarding their visual perception of color and peri-implant soft margin architecture and harmony in the implant region using the photographs obtained at T4. Result The clinical results showed significant changes to the height of the peri-implant soft margin, but the photographic results did not show significant changes for this measurement. The thickness of the attached gingiva was maintained during all the observation period. Of the professionals interviewed, 35.2% noticed an altered peri-implant soft margin color of the implant region, 39.8% noticed a change in the peri-implant soft margin architecture and 12.5% noticed a change in the peri-implant soft margin harmony. Conclusion The soft tissues around immediate implants changed during this period, but did not affect the aesthetic outcome and in the opinion of professionals, the aesthetic results were satisfactory for these cases.

To perform different dental procedures it is currently necessary to make a correct assessment of periodontal biotype, using the right tools that allow its thickness to be accurately measured. The objective of this study was to evaluate different diagnostic methods and correlating them with direct measurement of width and thickness of attached gingiva in the front upper jaw area. The study included 30 periodontally healthy patients, in whom biotype identification was performed on teeth 1.1, 1.2 and 1.3, using visual parameters, direct measurement of the width and attached gingiva thickness, and transparency of the periodontal probe as an indirect method. According to the transparency of the probe, the thick biotype was the most frequent (53.3%) was observed more in men (62.5%) than women (37.50%). According to the visual parameters, thin biotype was more prevalent (56.7%) than the thick biotype (43.3%). There were no significant differences on comparing the 2 methods. The mean width of attached gingiva was 2.79 mm and a thickness of 1.06 mm, being greater in the thick biotype (width 2.94 mm and thickness 1.10) than in the thin biotype (width 2.67 mm and thickness 1.01 mm). According to the results, it can be concluded that both the visual diagnosis and transparency of the probe are valid to identify the gingival biotype. However, a lower reproducibility by visual inspection was observed, and the thin biotype showed a higher error rate.

Actualmente, para realizar distintos procedimientos odontológicos se hace necesaria una correcta evaluación del biotipo periodontal utilizando las herramientas adecuadas que nos permitan medir de manera certera su grosor. El objetivo de esta investigación fue evaluar distintos métodos diagnósticos, correlacionándolos con la medición directa de ancho y grosor de encía adherida en la zona anterosuperior del maxilar. Se reclutaron 30 pacientes periodontalmente sanos, y en los dientes 1.1, 1.2 y 1.3 se realizó: identificación del biotipo según parámetros visuales, medición directa del ancho, grosor de encía adherida y transparencia de la sonda periodontal como método indirecto. Mediante la transparencia de la sonda, el biotipo grueso fue el más prevalente (53,3%), observándose más en hombres (62,5%) versus mujeres (37,50%). Según parámetros visuales, el biotipo fino fue más prevalente (56,7%) que el grueso (43,3%), y al comparar ambos métodos no existieron diferencias significativas. Se observó un ancho promedio de la encía adherida de 2,79 mm y un grosor de 1,06 mm, presentándose valores más elevados en el biotipo grueso (ancho 2,94 mm y grosor 1,10 mm) versus el fino (ancho 2,67 mm y grosor 1,01 mm). Según los resultados obtenidos podemos concluir que tanto el diagnóstico visual como la transparencia de la sonda son válidos para identificar el biotipo gingival. Sin embargo, la inspección visual mostró menor reproducibilidad y mayor porcentaje de error al definir biotipo fino.

INTRODUCCIÓN:las recesiones del tejido marginal presentan problemas estéticos, sensibilidad dental, caries radicular y dificultad para hacer una adecuada higiene oral. Existen diversas técnicas de cirugía plástica periodontal para el cubrimiento radicular. El objetivo de esta revisión de literatura es evaluar los factores asociados a la técnica de colgajo posicionado coronal para el cubrimiento de recesiones gingivales, teniendo en cuenta que hay diferentes variables que pueden intervenir en el cubrimiento completo de la superficie radicular. MÉTODOS: revisión de literatura sobre la técnica de colgajo posicionado coronal para cubrimiento de recesiones tipo I y II de Miller de uno o dos dientes. Se tomaron artículos desde el año 2000 al 2012, buscados en las bases de datos PubMed, Ebsco y Cochrane, de estudios hechos en humanos de tipo longitudinales, transversales, de cohorte, ensayos clínicos y meta análisis. RESULTADOS Y CONCLUSIONES: la altura de la papila interdental, el ancho de encía queratinizada y el espesor gingival son factores de pronóstico para el cubrimiento total radicular y su estabilidad a largo plazo. La integridad de la unión amelocementaria es importante para el diagnóstico y el éxito de la técnica, además, un pre-requisito es la modificación de la superficie radicular con técnicas mecánicas y/o químicas. La técnica de colgajo avanzado coronal combinada con tejido conectivo, matriz derivada del esmalte, colágeno porcino o matriz dérmica, son efectivas para el tratamiento de las retracciones gingivales tipo I y II de Miller, pero la de mayor predictibilidad es la técnica bilaminar con tejido conectivo.

INTRODUCTION:marginal tissue recessions produce esthetic problems, tooth sensitivity, root caries, and difficulty to perform proper oral hygiene. There are various periodontal plastic surgery techniques for root coverage. The goal of this literature review is to assess factors associated with the coronally positioned flap technique to cover gingival recessions, bearing in mind that several variables can intervene in the complete coverage of root surface. METHODS: this was a literature review on the coronally positioned flap technique for coverage of Miller class I and class II recessions of one or two teeth. It included articles published between 2000 and 2012 by searching the PubMed, Ebsco, and Cochrane databases for studies performed in humans, including longitudinal, transverse, and cohort studies, as well as clinical trials and meta-analyses. RESULTS AND CONCLUSIONS:interdental papilla height, keratinized gingiva width, and gingival thickness are prognostic factors for total root coverage and its long-term stability. Integrity of the cemento-enamel junction is important in diagnosis and success of the technique; moreover, modification of root surface with technical and/or chemical mechanisms is a prerequisite. The coronally advanced flap technique combined with connective tissue, enamel matrix derivative, porcine collagen, or dermal matrix is effective in the treatment of Miller class I and class II gingival recessions, but the one with the greatest predictability is the bilaminar technique with connective tissue.

The normal grow and development of the maxilla and the patterns of teeth eruption demand a constant accommodation of the periodontal tissues. The genetic influence may be determinant in the thickness the periodontium will have and the location of the dental germs in the alveolar process, and it also could be conditioning the size of the alveolar process and the thickness of the keratinized gingiva. Carrying out an orthodontic treatment without considering the periodontal basis could be very iatrogenic, so the combined work and the periodical control are essential. Mucogingival surgery includes surgical procedures designed to correct defects in the morphology, position and dimensions of the gingiva around the tooth. The free autograft of the connective tissue and epithelium is a versatile surgical procedure, relatively simple, that can increase the depth of the vestibule and the quantity of adhered gingiva. We present the case of a nine-years-old patient with periodontal recession and scarce keratinized gingiva, with the purpose of describing the potential usage of the free autograft of the connective tissue and the epithelium in procedures of root covering and as a coadjuvant of the orthodontic treatment.

El normal crecimiento y desarrollo del maxilar y los patrones de erupción de los dientes exigen una acomodación constante por parte de los tejidos periodontales. La influencia genética puede ser determinante en el espesor que tendrá el periodonto y la ubicación de los gérmenes dentarios en el proceso alveolar, así como puede estar condicionando el tamaño del proceso alveolar y el espesor de encía queratinizada . Llevar a cabo un tratamiento de ortodoncia sin considerar el terreno periodontal puede llegar a hacer muy iatrogénico, por lo que el trabajo en conjunto y el control periódico son fundamentales. La cirugía mucogingival incluye procedimientos quirúrgicos diseñados para corregir defectos en la morfología, posición y dimensiones de la encía alrededor del diente. El autoinjerto libre de tejido conectivo y epitelio (ALTCE) es un procedimiento quirúrgico versátil, relativamente simple, que puede aumentar la profundidad del vestíbulo y la cantidad de encía adherida. Se presenta el caso de una paciente de 9 años de edad con recesión periodontal y escasa encía queratinizada, con el propósito de describir el uso potencial del autoinjerto libre de tejido conectivo y epitelio en procedimientos de cobertura radicular y como coadyuvante del tratamiento ortodóntico.

Pacientes fumantes freqüentemente apresentam redução dos sinais clínicos inflamatórios da gengivite, associada, em grande parte, a vasoconstrição local e aumento da espessura epitelial. O objetivo deste trabalho foi avaliar a espessura do epitélio oral da gengiva marginal de pacientes fumantes e não fumantes, nos estados de saúde gengival e gengivite. Foram obtidos vinte fragmentos de tecido gengival de quatro grupos de pacientes. Grupo I: não fumantes com saúde gengival (n = 5). Grupo II: não fumantes com gengivite (n = 5). Grupo III: fumantes com saúde gengival (n = 5). Grupo IV: fumantes com gengivite (n = 5). As biópsias receberam processamento histológico de rotina, e os cortes semi-seriados com 5 mm de espessura foram corados com H. E. Com auxílio do sistema de imagens KS400 foram quantificadas a espessura epitelial maior e a espessura da base epitelial e determinados os valores dos perímetros epiteliais externo e interno. Os dados foram avaliados pelo ANOVA e pelo teste de Tukey, considerando significativo o valor de a = 0,05. Os resultados mostraram valores da espessura da base epitelial maior (p < 0,05) nos pacientes fumantes, independentemente do estado de saúde gengival.

Smoking patients show reduction of inflammatory clinical signs that might be associated with local vasoconstriction and an increased gingival epithelial thickness. The purpose of this work was to evaluate the thickness of the marginal gingival oral epithelium in smokers and non-smokers, with clinically healthy gingivae or with gingivitis. Twenty biopsies were obtained from four different groups. Group I: non-smokers with clinically healthy gingivae (n = 5). Group II: non-smokers with gingivitis (n = 5). Group III: smokers with clinically healthy gingivae (n = 5). Group IV: smokers with gingivitis (n = 5). These biopsies were histologically processed, serially sectioned at 5 mm, stained with H. E., and examined by image analysis software (KS400), which was used to perform the morphometric evaluation and the quantification of the major epithelial thickness, the epithelial base thickness and the external and internal epithelial perimeters. Differences between the four groups were analyzed using ANOVA test and Tukey's test. The criteria for statistical significance were accepted at the probability level p < 0.05. A greater epithelial thickness was observed in smokers independent of the gingival health situation.