Reposicionamento coronal do retalho para recobrimento de recessões gengivais múltiplas utilizando matriz de colágeno tridimensional associada às proteínas derivadas da matriz do esmalte – série de casos

Flávia Sukekava, Julia Helena Luiz, Jaques Luiz
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Abstract

Gingival recession is the generic term that means exposure of the teeth root surface. It can cause aesthetic problems, dentin hypersensitivity or even favor the appearance of root caries. Depending on the patients complaint, it can be treated in different ways, such as through direct resin restorations, root desensitization or even surgical root coverage. The latter can be obtained through coronal/lateral repositioning of the flap with or without a connective tissue graft. Currently, the removal of subepithelial connective tissue graft from the patients palate be replaced by 3D collagen matrices, generating satisfactory aesthetic results. The aim of this case series was to evaluate the evolution of root coverage treatment using the protocol for covering multiple gingival recessions with the association of soft tissue substitute and enamel matrix-derivative proteins. Seven systemic healthy adult patients complaining of root exposure sought at our clinic. Coronal flap repositioning associated with soft tissue substitute and enamel matrix-derivative proteins was proposed. All patients were treated with the same surgical technique. At the end of 30 months postoperatively, the patients self-reported satisfactory results, with root coverage close to 85% and total coverage in 50% of the treated teeth, with no complaints of pain, considerable edema and/or hemorrhage in the immediate postoperative period. This protocol used seems to obtain satisfactory results regarding aesthetic complaints or dentin hypersensitivity reported by patients at the beginning of treatment.
冠状皮瓣重新定位,以覆盖多个牙龈衰退使用三维胶原基质与来自牙釉质基质的蛋白质-病例系列
牙龈萎缩是指牙齿根部表面暴露的通用术语。它会导致美观问题,牙本质过敏,甚至有利于牙根龋的外观。根据患者的投诉,可以通过不同的方式治疗,如直接树脂修复,根脱敏甚至手术根覆盖。后者可通过带或不带结缔组织移植物的冠状/外侧皮瓣重新定位获得。目前,从患者上颚移除的上皮下结缔组织移植物可被3D胶原基质代替,产生满意的美学效果。本病例系列的目的是评估使用与软组织替代品和牙釉质基质衍生物蛋白相关的方案覆盖多种牙龈衰退的根覆盖治疗的演变。7名全身性健康成人患者抱怨根暴露寻求在我们的诊所。冠状皮瓣重新定位与软组织替代物和牙釉质基质衍生物蛋白相关。所有患者均采用相同的手术技术。在术后30个月结束时,患者自我报告满意的结果,牙根覆盖率接近85%,治疗牙齿的总覆盖率为50%,术后立即无疼痛、明显水肿和/或出血的主诉。该方案似乎获得满意的结果关于美观投诉或牙本质过敏报告的患者在治疗开始。
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