Avaliação clínica do uso do Alloderm®, enxerto conjuntivo e retalho reposicionado coronariamente no tratamento da recessão gengival

• Ano de defesa: 2006
• Autor(a) principal: Vieira, Esio de Oliveira
• Orientador(a): Fischer, Ricardo Guimarães
• Banca de defesa: Figueredo, Carlos Marcelo da Silva , Machado, Walter Augusto Soares , Terezan, Marilisa Lugon Ferreira , Kahn, Sérgio , Santana, Ronaldo Barcellos de
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade do Estado do Rio de Janeiro
• Programa de Pós-Graduação: Programa de Pós-Graduação em Odontologia
• Departamento: Centro Biomédico::Faculdade de Odontologia
• País: BR
• Palavras-chave em Português: Cirurgia peridontal; Alloderm; Recessão gengival; Enxerto de tecido conjuntivo; Retalho reposicionado
• Palavras-chave em Inglês: Periodontal surgical; Alloderm; Gingival recession; Subepithelial connective tissue graft; Coronally advanced flap
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA::PERIODONTIA
• Link de acesso: http://www.bdtd.uerj.br/handle/1/13950

The aim of the present study was to clinically evaluate the subepithelial connective tissue graft (CTG), Alloderm (ALL) and coronally advanced flap (CAF) in the treatment of gingival recessions Class I of Miller. 30 patients were included in the study, and were divided in 3 groups of 10 patients. 10 patients with mean age of 38.7 (± 10,3) years were treated with CAF, including 18 defects. 10 patients with mean age of 40.2(± 9.9) years were treated with CTG, including 23 defects, while 10 patients with mean age of 37.7(±11.2) were treated with ALL, including 18 gingival recessions. The patients should not have caries over the denuded root surface, the cementoename junction should visible and easily identified, should not have received any surgical treatment during the last 24 months, and not have periodontal pockets or endodontic treatment at the tested teeth. The following measurements were performed: Plaque index (PI), gingival index (GI), probing pocket depth (PPD), probing attachment level (PAL), width of keratinized gingiva (KG), depth of gingival recession (GR) and position of the mucogingival junction (MGJ). PI, GI, PPD, PAL, KG, GR, MGJ were made with a calibrated periodontal probe on days 0, 30, 60, 90, 120 and 180. PPD and PAL were not measured on day 30. Subjective evaluations were performed by the patient and the dentist on day 180. Paired T Test was used to observe differences within the groups in the different time periods, and ANOVA was performed to analyze differences between the 3 surgical procedures (p<0.05). The results showed that the mean root coverage was 66.8% for the CAF group, while the corresponding values for ALL and CTG were 775.9% and 81.4%, respectively. There was no significant difference between the values of ALL and CO, but the mean values for root coverage of CO group were statistically higher than the CAF group. The mean values of clinical attachment gain of 4.2 (± 0.9) mm and 3.5 (± 1.0) mm in CTG and ALL groups, respectively, were statistically higher than the corresponding values for CAF group (2.1 ± 0.7 mm). There was no significant difference between the mean increase of KG of 1.4 (± 0.3) mm in CTG group and 1.3(± 0.2) mm in ALL group. KG was not different in the CAF group. In conclusion, CTG and ALL procedures presented similar and better results than CAF procedure in relation to clinical attachment gain, increase in the width of KG and the % of root coverage