1
|
Huamán-Mendoza AA, Reis INRD, Ganhito JA, Carvalho CV, Micheli GD, Pannuti CM. Current state about root coverage using soft-tissue substitutes in the presence of noncarious cervical lesions: A literature review. J Indian Soc Periodontol 2023; 27:344-351. [PMID: 37593556 PMCID: PMC10431232 DOI: 10.4103/jisp.jisp_388_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/05/2023] [Accepted: 01/08/2023] [Indexed: 08/19/2023] Open
Abstract
About half of the cases of gingival recession are associated with the noncarious cervical lesion (NCCL), resulting in combined defects (CDs). NCCL negatively affects the root coverage outcomes. In addition, considering the morbidity associated with graft harvesting, soft-tissue substitutes (STSs) appeared as a suitable option for connective tissue grafts for surgical root coverage. Currently, the literature addressing the therapy of CDs employing STSs is scarce. Thus, the present review aimed to update the literature and outline the future perspectives about root coverage of CDs using STSs. A detailed literature search was conducted on MEDLINE, Web of Science, EMBASE, LILACS, Scopus, and Google Scholar databases using keywords and Boolean operators. Randomized clinical trials (2) and case reports (6) were included. None of the selected studies reported any adverse effect using STSs. Based on the limited evidence available, we cannot state that STSs may benefit the periodontal clinical and patient-centered outcomes. Randomized controlled trials are needed to assess the long-term outcomes, surgical approaches, and restorative protocols.
Collapse
Affiliation(s)
| | | | - Juliana Assef Ganhito
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Giorgio De Micheli
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Claudio Mendes Pannuti
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
2
|
Meza-Mauricio J, Mourão ERST, Oliveira Marinho K, Vergara-Buenaventura A, Mendoza-Azpur G, Muniz FWMG, Santamaria MP, Faveri M. Effect of collagen sponge and flowable resin composite on pain management after free gingival graft harvesting: A randomized controlled clinical trial. Eur J Oral Sci 2023; 131:e12935. [PMID: 37169726 DOI: 10.1111/eos.12935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/25/2023] [Indexed: 05/13/2023]
Abstract
The aim of this study was to compare the effect of the application of a flowable resin composite coating, over a collagen sponge stabilized with suture, on postoperative pain after free gingival graft harvesting. Thirty-two free gingival grafts were harvested from the palate in 32 patients, who were subsequently randomized to have only a collagen sponge stabilized with sutures applied to the palatal wound (control), or to have the collagen sponge coated with a flowable resin composite (test). Patients were observed for 14 days, and the pain level was evaluated by using a numerical rating scale. The consumption of analgesics during the postoperative period and the characteristic of the graft were also analyzed. The patients in the test group reported having experienced significantly less pain statistically than the patients in the control group throughout the study. The consumption of analgesics was lower in the test group. The dimensions of harvested grafts in the control and test groups showed no significant differences in height, width, and thickness. In conclusion, the addition of flowable resin composite coating to the hemostatic collagen sponge on the palatal wound following free gingival graft harvesting helped to minimize postoperative pain.
Collapse
Affiliation(s)
| | | | - Kelson Oliveira Marinho
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, São Paulo, Brazil
| | | | | | | | | | - Marcelo Faveri
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, São Paulo, Brazil
| |
Collapse
|
3
|
Mathias-Santamaria IF, Santamaria MP, Silveira CA, Martinho FC, de Melo MAS, De Marco AC, Augusto MG, de Andrade GS, Roulet JF, Bresciani E. Evaluation of a novel restorative protocol to treat non-carious cervical lesion associated with gingival recession: a 2-year follow-up randomized clinical trial. Clin Oral Investig 2023; 27:1781-1792. [PMID: 36462038 DOI: 10.1007/s00784-022-04806-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/27/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE To compare 2 different resin composites and 2 adhesive systems used in a new restorative protocol (partial restoration) to treat non-carious cervical lesions associated with gingival recession type 1 (RT1). MATERIAL AND METHODS Eighty combined defects (CDs) were treated with a partial restoration and periodontal plastic surgery for root coverage. The CDs were randomly assigned to one of the following groups: NP + TE (n = 20), nanofilled composite and 2-step total-etch adhesive system; NP + UA (n = 20), nanofilled composite and universal adhesive system; MH + TE (n = 20), microhybrid composite and 2-step total-etch adhesive; MH + UA (n = 20), microhybrid composite and universal adhesive. Restorations were assessed using the United States Public Health Service (USPHS) criteria at 1 week (baseline) and 6, 12, and 24 months. Survival rate, periodontal parameters, dentin hypersensitivity (DH), and aesthetics were also evaluated. RESULTS After 24 months, only the MH + TE group did not lose any restoration, with no significant differences between groups. For surface roughness parameter, MH presented 83.3% of the restorations scoring Bravo, whereas NP presented 48.5% of the restorations scoring Bravo. All groups presented restorations with marginal discoloration. All periodontal parameters behaved similarly, regardless of the restorative material. All groups presented significant reductions of dentin hypersensitivity and improved aesthetic perceptions (p < 0.05). CONCLUSION Both resin composites and adhesives tested can be combined for partial restorations to treat CDs. CLINICAL RELEVANCE This new restorative-surgical protocol to treat CDs presents satisfactory outcomes. The partial restorations can be successfully executed with both combinations of adhesives and resin composites evaluated in this investigation. TRN : ClinicalTrial.gov: NCT03215615; registration date July 12, 2017.
Collapse
Affiliation(s)
- Ingrid Fernandes Mathias-Santamaria
- Department of General Dentistry, School of Dentistry, University of Maryland, Baltimore, 650 West Baltimore Street, Baltimore, MD, 21201, USA.
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - São Paulo State University, São José Dos Campos, Brazil.
| | - Mauro Pedrine Santamaria
- Department of Diagnosis and Surgery, Institute of Science and Technology, UNESP - São Paulo State University, São José Dos Campos, Brazil
- Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, USA
| | - Camila Augusto Silveira
- Department of Diagnosis and Surgery, Institute of Science and Technology, UNESP - São Paulo State University, São José Dos Campos, Brazil
| | - Frederico Canato Martinho
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Baltimore, MD, USA
| | - Mary Anne Sampaio de Melo
- Department of General Dentistry, School of Dentistry, University of Maryland, Baltimore, 650 West Baltimore Street, Baltimore, MD, 21201, USA
| | - Andrea Carvalho De Marco
- Department of Diagnosis and Surgery, Institute of Science and Technology, UNESP - São Paulo State University, São José Dos Campos, Brazil
| | - Marina Gullo Augusto
- Department of Dentistry, School of Dentistry, Western Paraná State University, Cascavel, Brazil
| | | | - Jean-François Roulet
- Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, USA
| | - Eduardo Bresciani
- Department of Restorative Dentistry, Institute of Science and Technology, UNESP - São Paulo State University, São José Dos Campos, Brazil
| |
Collapse
|
4
|
Antezack A, Ohanessian R, Sadowski C, Faure-Brac M, Brincat A, Etchecopar-Etchart D, Monnet-Corti V. Effectiveness of surgical root coverage on dentin hypersensitivity: A systematic review and meta-analysis. J Clin Periodontol 2022; 49:840-851. [PMID: 35634650 DOI: 10.1111/jcpe.13664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 11/30/2022]
Abstract
AIM To assess the effect of surgical root coverage (RC) on dentin hypersensitivity (DH) associated with gingival recession. MATERIALS AND METHODS Two independent reviewers conducted electronic literature searches in MEDLINE (PubMed), EMBASE, Cochrane Library, Web Of Science, Dentistry & Oral Sciences Source, ScienceDirect, and ClinicalTrials.gov databases as well as a manual search to identify eligible clinical studies from January 2000 to March 2022. Randomized controlled trials (RCTs) comparing two surgical RC techniques or a surgical RC technique with or without adjuvant were included. Meta-analyses were performed on data provided by RCTs. RESULTS Thirteen RCTs with a total of 701 patients (1086 recessions) were included. The percentage of DH suppression was 70.8% (95% confidence interval [CI] [64.4-76.6]; I2 = 39.2% [3.5-61.8], Q-test = 0.02) after surgical RC. Recession reduction and percentage of RC were both statistically significantly associated with DH suppression (estimate = 0.66 [0.10-1.23], p = .022, R2 = 14.45% and estimate = 0.04 [0.01-0.08], p = .012, R2 = 29.54%, respectively). Coronally advanced flap (CAF) + connective tissue graft showed results statistically more effective than CAF + xenogeneic collagen matrix in DH suppression (73.3% [65.6-79.8] and 61.4% [51.7-70.3], respectively; p = .048). CONCLUSIONS Success of surgical RC is associated with DH suppression.
Collapse
Affiliation(s)
- Angéline Antezack
- Faculté des Sciences Médicales et Paramédicales, Ecole de Médecine Dentaire, Aix-Marseille Université, Provence-Alpes-Côte D'azur, Marseille, France.,Assistance Publique-Hopitaux de Marseille (AP-HM), Hopital Timone, Provence-Alpes-Côte D'azur, Marseille, France.,UMR D-258 Microbes Evolution Phylogénie et Infection (MEPHI), Institut de Recherche Pour Le Développement (IRD), Aix-Marseille Université, Provence-Alpes-Côte D'azur, Marseille, France
| | - Romain Ohanessian
- Faculté des Sciences Médicales et Paramédicales, Ecole de Médecine Dentaire, Aix-Marseille Université, Provence-Alpes-Côte D'azur, Marseille, France.,Assistance Publique-Hopitaux de Marseille (AP-HM), Hopital Timone, Provence-Alpes-Côte D'azur, Marseille, France
| | - Camille Sadowski
- Faculté des Sciences Médicales et Paramédicales, Ecole de Médecine Dentaire, Aix-Marseille Université, Provence-Alpes-Côte D'azur, Marseille, France.,Assistance Publique-Hopitaux de Marseille (AP-HM), Hopital Timone, Provence-Alpes-Côte D'azur, Marseille, France
| | - Mathias Faure-Brac
- Faculté des Sciences Médicales et Paramédicales, Ecole de Médecine Dentaire, Aix-Marseille Université, Provence-Alpes-Côte D'azur, Marseille, France.,Assistance Publique-Hopitaux de Marseille (AP-HM), Hopital Timone, Provence-Alpes-Côte D'azur, Marseille, France
| | - Arthur Brincat
- Faculté des Sciences Médicales et Paramédicales, Ecole de Médecine Dentaire, Aix-Marseille Université, Provence-Alpes-Côte D'azur, Marseille, France.,Assistance Publique-Hopitaux de Marseille (AP-HM), Hopital Timone, Provence-Alpes-Côte D'azur, Marseille, France
| | - Damien Etchecopar-Etchart
- EA 3279: CEREeSS-Health Service Research and Quality of Life Center, Aix-Marseille Université, Département de Psychiatrie, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, Provence-Alpes-Côte D'azur, France
| | - Virginie Monnet-Corti
- Faculté des Sciences Médicales et Paramédicales, Ecole de Médecine Dentaire, Aix-Marseille Université, Provence-Alpes-Côte D'azur, Marseille, France.,Assistance Publique-Hopitaux de Marseille (AP-HM), Hopital Timone, Provence-Alpes-Côte D'azur, Marseille, France.,UMR D-258 Microbes Evolution Phylogénie et Infection (MEPHI), Institut de Recherche Pour Le Développement (IRD), Aix-Marseille Université, Provence-Alpes-Côte D'azur, Marseille, France
| |
Collapse
|
5
|
Deep Margin Elevation: A Literature Review. Dent J (Basel) 2022; 10:dj10030048. [PMID: 35323250 PMCID: PMC8947734 DOI: 10.3390/dj10030048] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/04/2022] [Accepted: 03/10/2022] [Indexed: 01/02/2023] Open
Abstract
A conservative approach for restoring deep proximal lesions is to apply an increment of composite resin over the preexisting cervical margin to relocate it coronally, the so-called “deep margin elevation” (DME). A literature search for research articles referring to DME published from January 1998 until November 2021 was conducted using MEDLINE (PubMed), Ovid, Scopus, Cochrane Library and Semantic Scholar databases applying preset inclusion and exclusion criteria. Elevation material and adhesive system employed for luting seem to be significant factors concerning the marginal adaptation of the restoration. This technique does not affect bond strength, fatigue behavior, fracture resistance, failure pattern or repairability. DME and subgingival restorations are compatible with periodontal health, given that they are well-polished and refined. The available literature is limited mainly to in vitro studies. Therefore, randomized clinical trials with extended follow-up periods are necessary to clarify all aspects of the technique and ascertain its validity in clinical practice. For the time being, DME should be applied with caution respecting three criteria: capability of field isolation, the perfect seal of the cervical margin provided by the matrix, and no invasion of the connective compartment of biological width.
Collapse
|
6
|
Grassi EDA, de Andrade GS, Tribst JPM, Machry RV, Valandro LF, Ramos NDC, Bresciani E, Saavedra GDSFA. Fatigue behavior and stress distribution of molars restored with MOD inlays with and without deep margin elevation. Clin Oral Investig 2021; 26:2513-2526. [PMID: 34643807 DOI: 10.1007/s00784-021-04219-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study evaluated the effect of deep margin elevation (DME) and restorative materials (leucite-reinforced glass-ceramics [C] vs. indirect resin composite [R]) on the fatigue behavior and stress distribution of maxillary molars with 2-mm deep proximal margins restored with MOD inlay. METHODS Fifty-two extracted human third molars were randomly assigned into four groups (n = 13): C; DME + C; R; and DME + R. Inlays were fabricated in CAD-CAM and bonded to all teeth. The fatigue behavior was assessed with the stepwise stress test (10,000 cycles/step; step = 50 N; 20 Hz; initial load = 200 N). Fatigue failure loads and the number of cycles were analyzed with 2-way ANOVA and Tukey's test (p < 0.05) and Kaplan-Meier survival plots. The stress distribution was assessed with finite element analysis. The models were considered isotropic, linear, and homogeneous, and presented bonded contacts. A tripod axial load (400 N) was applied to the occlusal surface. The stress distribution was analyzed with the maximum principal stress criterion. RESULTS For fatigue, there was no difference for DME factor (p > 0.05). For the material factor, the load and number of cycles for failure were statistically higher in the R groups (p < 0.05). The finite element analysis showed that resin composite inlays concentrated more stress in the tooth structure, while ceramic inlays concentrated more stress in the restoration. Non-reparable failures were more frequent in the resin composite inlays groups. CONCLUSIONS DME was not negative for fatigue and biomechanical behaviors. Resin composite inlays were more resistant to the fatigue test, although the failure mode was more aggressive. CLINICAL SIGNIFICANCE DME does not impair mechanical behavior. Resin composite inlays failed at higher loads but with a more aggressive failure mode.
Collapse
Affiliation(s)
- Elisa Donaria Aboucauch Grassi
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), 777th Eng. Francisco José Longo Av., São José dos Campos, SP, 12245-000, Brazil
| | - Guilherme Schmitt de Andrade
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), 777th Eng. Francisco José Longo Av., São José dos Campos, SP, 12245-000, Brazil
| | - João Paulo Mendes Tribst
- Post-Graduate Program in Dentistry, University of Taubaté (UNITAU), 09th Rua Dos Operários St., Taubaté, SP, 12020-340, Brazil
| | - Renan Vaz Machry
- Graduate Program of Oral Science, Prosthodontics Unit, School of Dentistry, Federal University of Santa Maria (UFSM), Roraima Av, Santa Maria, RS, 100097105-340, Brazil
| | - Luiz Felipe Valandro
- Graduate Program of Oral Science, Prosthodontics Unit, School of Dentistry, Federal University of Santa Maria (UFSM), Roraima Av, Santa Maria, RS, 100097105-340, Brazil
| | - Nathalia de Carvalho Ramos
- School of Dentistry, São Francisco University (USF), 218th São Francisco de Assis Av., Bragança Paulista, SP, 12916-900, Brazil
| | - Eduardo Bresciani
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (Unesp), 777th Eng. Francisco José Longo Av., São José dos Campos, SP, 12245-000, Brazil
| | - Guilherme de Siqueira Ferreira Anzaloni Saavedra
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), 777th Eng. Francisco José Longo Av., São José dos Campos, SP, 12245-000, Brazil.
| |
Collapse
|
7
|
Santamaria MP, Mathias-Santamaria IF, Ferraz LFF, Casarin RCV, Romito GA, Sallum EA, Pini-Prato GP, Casati MZ. Rethinking the decision-making process to treat gingival recession associated with non-carious cervical lesions. Braz Oral Res 2021; 35:e096. [PMID: 34586210 DOI: 10.1590/1807-3107bor-2021.vol35.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 11/21/2022] Open
Abstract
The presence of a tooth-surface defect, such as a non-carious cervical lesion (NCCL), associated with sites of gingival recession (GR) defects creates a combined soft tissue/tooth defect (CD) that requires a different treatment plan. This study aimed to critically review the literature regarding the available treatment protocols for CDs and suggest a new decision-making process. NCCLs were classified as Class A-: the cementoenamel junction (CEJ) was visible and the root surface discrepancy was < 0.5 mm (no step); Class A+: CEJ was visible and the root surface discrepancy was > 0.5 mm (with a step); Class B-: unidentifiable CEJ without a step; Class B+: unidentifiable CEJ with a step. NCCLs affecting both root and crown surfaces (Class B) lead to CEJ destruction and consequently eliminate an important landmark used before and after root coverage procedures. The depth of the root surface discrepancy is vital owing to its possible impact on soft tissue adaptation after healing, which, in turn, may influence the treatment options, namely the use of graft and/or composites to compensate for the discrepancy. Clinically, a step with horizontal depth greater than 0.5 mm should be recognized as the minimum threshold value to define this condition. Extremely deep defects tend to assume a V-shaped topography. Therefore, extremely deep V-shaped defects were classified into subclasses A+V, a V-shaped defect, and B+V, a V-shaped defect with loss of CEJ, for management considerations. The treatment options, supported by the literature, and a decision-making process to deal with each condition are presented.
Collapse
Affiliation(s)
- Mauro Pedrine Santamaria
- Universidade Estadual Paulista - Unesp, Institute of Science and Technology, Department of Diagnosis and Surgery, São José dos Campos, SP, Brazil
| | - Ingrid Fernandes Mathias-Santamaria
- Universidade Estadual Paulista - Unesp, Institute of Science and Technology, Department of Diagnosis and Surgery, São José dos Campos, SP, Brazil
| | - Laís Fernanda Ferreira Ferraz
- Universidade Estadual Paulista - Unesp, Institute of Science and Technology, Department of Diagnosis and Surgery, São José dos Campos, SP, Brazil
| | - Renato Corrêa Viana Casarin
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Prosthodontics and Periodontics, Piracicaba, SP, Brazil
| | - Giuseppe Alexandre Romito
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | - Enilson Antônio Sallum
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Prosthodontics and Periodontics, Piracicaba, SP, Brazil
| | | | - Márcio Zaffalon Casati
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Prosthodontics and Periodontics, Piracicaba, SP, Brazil
| |
Collapse
|
8
|
Mathias-Santamaria IF, Silveira CA, Rossato A, Sampaio de Melo MA, Bresciani E, Santamaria MP. Single gingival recession associated with non-carious cervical lesion treated by partial restoration and coronally advanced flap with or without xenogenous collagen matrix: A randomized clinical trial evaluating the coverage procedures and restorative protocol. J Periodontol 2021; 93:504-514. [PMID: 34310715 DOI: 10.1002/jper.21-0358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Evaluate the use of collagen matrix (CM) as adjunctive to coronally advanced flap (CAF versus CAF + CM) to treat gingival recession (GR) associated with non-carious cervical lesion-combined defects (CDs). METHODS Sixty-two patients presenting 62 CDs (RT1 GR and non-carious cervical lesion (NCCLs) were randomly allocated to either CAF group (n = 31): partial restoration of the NCCL and CAF; or to CAF + CM group (n = 31): partial restoration of the NCCL and CAF associated with CM. Clinical, esthetic, patient-centered outcomes, and restorative parameters were assessed. RESULTS After 12 months, CD coverage were 55.2% for CAF and 54.4% for CAF + CM (P = 0.8). Recession reduction were 1.9 ± 0.8 mm for CAF and 2.0 ± 0.7 mm for CAF + CM (P = 0.6). CAF+CM resulted in higher increase in keratinized tissue (KT) width (CAF: 0.3 ± 0.7 mm; CAF + CM: 0.9 ± 0.8 mm; P = 0.004) and KT thickness gain (CAF: 0.1 ± 0.3 mm; CAF + CM: 0.7 ± 0.2 mm; P = 0.001). Both treatments presented low postoperative pain and resulted in esthetics improvements. In addition, no restoration was lost, 27.4% showed a reduction of the superficial polishing, and 8% showed marginal staining, but still clinically acceptable. CONCLUSION Partial resin composite restoration (with the apical limit up to 1 mm of the estimated CEJ) and CAF alone or combined with CM are suitable for treating CDs. The use of CM provided additional benefits in terms of KT width and thickness gain. (NCT03341598).
Collapse
Affiliation(s)
- Ingrid Fernandes Mathias-Santamaria
- UNESP Sao Paulo State University, Division of Periodontology, College of Dentistry, Sao Paulo, Brazil.,Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Camila Augusto Silveira
- UNESP Sao Paulo State University, Division of Periodontology, College of Dentistry, Sao Paulo, Brazil
| | - Amanda Rossato
- UNESP Sao Paulo State University, Division of Periodontology, College of Dentistry, Sao Paulo, Brazil
| | - Mary Anne Sampaio de Melo
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Eduardo Bresciani
- UNESP Sao Paulo State University, Division of Operative Dentistry, College of Dentistry, Sao Paulo, Brazil
| | - Mauro Pedrine Santamaria
- UNESP Sao Paulo State University, Division of Periodontology, College of Dentistry, Sao Paulo, Brazil.,College of Dentistry-Lexington, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
9
|
Adhesion of Flowable Resin Composites in Simulated Wedge-Shaped Cervical Lesions: An In Vitro Pilot Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11073173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The resin composite restoration of non-carious cervical lesions (NCCLs) still faces some drawbacks mostly related to the quality of the marginal seal. This study attempts to evaluate the adhesive capacities of two flowable and two conventional hybrid resin composite restorations of NCCLs having two types of cervical margins. Our null hypothesis assumes the same adhesive behavior of different materials. The relative composition of dental–restoration structures was also measured. Thus, restored wedge-shaped cervical cavities were realized on both the buccal and oral surfaces of extracted teeth. After immersion in dye solution, sectioning of the teeth was performed. We proposed an optical microscopy method to quantify the dye penetration along the restoration–tooth interface and scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDX) to evaluate the quality of the peripheral seal. The data obtained revealed an amount of dentinal microleakage for all tested materials, despite the favorable results of the restoration peripheral seal. Therefore, data from this study failed to reject the null hypothesis. The adhesion is not influenced by the position of cervical margins. The SEM revealed occasional disruptions of the adhesive interface. EDX sustains the qualitative compositions as provided by the manufacturers. Conclusions: The four experimental composites are recommended to restore NCCLs in clinic.
Collapse
|
10
|
Abstract
Gingival recession is a common finding in daily clinical practice. Several issues may be associated with the apical shift of the gingival margin such as dentine hypersensitivity, root caries, non-carious cervical lesions (NCCLs), and compromised aesthetics. The first step in an effective management and prevention program is to identify susceptibility factors and modifiable conditions associated with gingival recession. Non-surgical treatment options for gingival recession defects include establishment of optimal plaque control, removal of overhanging subgingival restorations, behaviour change interventions, and use of desensitising agents. In cases where a surgical approach is indicated, coronally advanced flap and tunnelling procedures combined with a connective tissue graft are considered the most predictable treatment options for single and multiple recession defects. If there is a contraindication for harvesting a connective tissue graft from the palate or the patient wants to avoid a donor site surgery, adjunctive use of acellular dermal matrices, collagen matrices, and/or enamel matrix derivatives can be a valuable treatment alternative. For gingival recession defects associated with NCCLs a combined restorative-surgical approach can provide favourable clinical outcomes. If a patient refuses a surgical intervention or there are other contraindications for an invasive approach, gingival conditions should be maintained with preventive measures. This paper gives a concise review on when and how to treat gingival recession defects.
Collapse
Affiliation(s)
- Jean-Claude Imber
- Department of Periodontology and Operative Dentistry, University of Mainz, Mainz, Germany; Department of Periodontology, University of Bern, Bern, Switzerland
| | - Adrian Kasaj
- Department of Periodontology and Operative Dentistry, University of Mainz, Mainz, Germany.
| |
Collapse
|
11
|
Oliveira LMLD, Souza CA, Cunha S, Siqueira R, Vajgel BDCF, Cimões R. Treatment efficacy of gingival recession defects associated with non-carious cervical lesions: a systematic review. J Periodontal Implant Sci 2021; 52:91-115. [PMID: 35505572 PMCID: PMC9064779 DOI: 10.5051/jpis.2102580129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 08/23/2021] [Accepted: 09/16/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose This systematic review aimed to compare the efficacy, defined in terms of the mean percentage of root coverage (mRC), of surgical treatment approaches combined with adhesive restorations of non-carious cervical lesions (NCCLs) to that of root coverage alone in patients with a single gingival recession (GR) and NCCL. Methods A literature search was conducted to identify longitudinal studies reporting the mRC following treatment for the correction of GR defects associated with NCCLs using a combination of surgical and restorative techniques in systemically and periodontally healthy patients. Results The search resulted in the retrieval of 12,409 records. Seven publications met the inclusion criteria for the qualitative synthesis of data. The mRCs ranged from 69% to 97%. In the medium term, the gingival margin position was more stable when a connective tissue graft (CTG) was used, independently of whether restoration of teeth with NCCLs was performed. Conclusions The strength of the evidence was limited by methodological heterogeneity in terms of study design as well as the unit and period of analysis, which precluded a meta-analysis. Although no definitive conclusion could be drawn due to the lack of sufficient evidence to estimate the effectiveness of the interventions, CTG-based procedures contributed to gingival margin stability regardless of the performance of restoration to treat NCCLs.
Collapse
Affiliation(s)
| | - Camila Agra Souza
- Department of Prosthetics and Orofacial Surgery, UFPE-Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Sinara Cunha
- Department of Prosthetics and Orofacial Surgery, UFPE-Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Rafael Siqueira
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - Renata Cimões
- Department of Prosthetics and Orofacial Surgery, UFPE-Universidade Federal de Pernambuco, Recife, PE, Brazil
| |
Collapse
|
12
|
Santamaria MP, Miguel MMV, Rossato A, Bonafé ACF, Ferraz LFF, Dos Santos LM, Mathias-Santamaria IF. New Volume-Stable Collagen Matrix and Modified Coronally Advanced Flap to Treat Multiple Gingival Recessions Associated with Partially Restored Non-Carious Cervical Lesions: A Case Report. Clin Adv Periodontics 2020; 12:69-74. [PMID: 33289326 DOI: 10.1002/cap.10142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/25/2020] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Gingival recession (GR) is a prevalent problem that is related to aesthetic demands and dentin hypersensitivity. Frequently, GR is associated with non-carious cervical lesion (NCCLs) forming a combined defect (CD), which requires restorative and surgical treatment. Connective tissue graft (CTG) procedures allow predictable root coverage but can result in patient discomfort and bleeding. CASE PRESENTATION This first case report describes multiple GRs associated with B+ NCCL at teeth #4 and 6 of a 27-year-old patient with a thin periodontal phenotype. The aim of this report was to evaluate the 6-month outcome of a new volume-stable collagen matrix (VCMX) combined with modified coronally advanced flap (MCAF) and partial restoration to treat CDs. After 6 months, significant improvement was observed regarding CD coverage (69.05%), recession reduction (RecRed) (2.25 mm), gingival thickness (GT) gain (0.74 mm) and keratinized tissue width (KTW) gain (0.75 mm). In addition, excellent aesthetic evaluation and patient comfort were achieved by using the biomaterial. CONCLUSION VCMX associated with MCAF and partial restoration may be an option to treat multiple recession defects plus B+ NCCLs. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Mauro Pedrine Santamaria
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Manuela Maria Viana Miguel
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Amanda Rossato
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Ana Carolina Ferreira Bonafé
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Laís Fernanda Ferreira Ferraz
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Lucio Murilo Dos Santos
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | | |
Collapse
|
13
|
Ercoli C, Caton JG. Dental prostheses and tooth-related factors. J Periodontol 2019; 89 Suppl 1:S223-S236. [PMID: 29926939 DOI: 10.1002/jper.16-0569] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 09/01/2017] [Accepted: 09/09/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVES This narrative review summarizes the current evidence about the role that the fabrication and presence of dental prostheses and tooth-related factors have on the initiation and progression of gingivitis and periodontitis. FINDINGS Placement of restoration margins within the junctional epithelium and supracrestal connective tissue attachment can be associated with gingival inflammation and, potentially, recession. The presence of fixed prostheses finish lines within the gingival sulcus or the wearing of partial, removable dental prostheses does not cause gingivitis if patients are compliant with self-performed plaque control and periodic maintenance. However, hypersensitivity reactions to the prosthesis dental material can be present. Procedures adopted for the fabrication of dental restorations and fixed prostheses have the potential to cause traumatic loss of periodontal supporting tissues. Tooth anatomic factors, root abnormalities, and fractures can act as plaque-retentive factors and increase the likelihood of gingivitis and periodontitis. CONCLUSIONS Tooth anatomic factors, such as root abnormalities and fractures, and tooth relationships in the dental arch and with the opposing dentition can enhance plaque retention. Restoration margins located within the gingival sulcus do not cause gingivitis if patients are compliant with self-performed plaque control and periodic maintenance. Tooth-supported and/or tooth-retained restorations and their design, fabrication, delivery, and materials have often been associated with plaque retention and loss of attachment. Hypersensitivity reactions can occur to dental materials. Restoration margins placed within the junctional epithelium and supracrestal connective tissue attachment can be associated with inflammation and, potentially, recession. However, the evidence in several of the reviewed areas, especially related to the biologic mechanisms by which these factors affect the periodontium, is not conclusive. This highlights the need for additional well-controlled animal studies to elucidate biologic mechanisms, as well as longitudinal prospective human trials. Adequate periodontal assessment and treatment, appropriate instructions, and motivation in self-performed plaque control and compliance to maintenance protocols appear to be the most important factors to limit or avoid potential negative effects on the periodontium caused by fixed and removable prostheses.
Collapse
Affiliation(s)
- Carlo Ercoli
- Departments of Periodontics and Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Jack G Caton
- Department of Periodontics, Eastman Institute for Oral Health, University of Rochester
| |
Collapse
|
14
|
Ercoli C, Caton JG. Dental prostheses and tooth-related factors. J Clin Periodontol 2019; 45 Suppl 20:S207-S218. [PMID: 29926482 DOI: 10.1111/jcpe.12950] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 09/01/2017] [Accepted: 09/09/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This narrative review summarizes the current evidence about the role that the fabrication and presence of dental prostheses and tooth-related factors have on the initiation and progression of gingivitis and periodontitis. FINDINGS Placement of restoration margins within the junctional epithelium and supracrestal connective tissue attachment can be associated with gingival inflammation and, potentially, recession. The presence of fixed prostheses finish lines within the gingival sulcus or the wearing of partial, removable dental prostheses does not cause gingivitis if patients are compliant with self-performed plaque control and periodic maintenance. However, hypersensitivity reactions to the prosthesis dental material can be present. Procedures adopted for the fabrication of dental restorations and fixed prostheses have the potential to cause traumatic loss of periodontal supporting tissues. Tooth anatomic factors, root abnormalities, and fractures can act as plaque-retentive factors and increase the likelihood of gingivitis and periodontitis. CONCLUSIONS Tooth anatomic factors, such as root abnormalities and fractures, and tooth relationships in the dental arch and with the opposing dentition can enhance plaque retention. Restoration margins located within the gingival sulcus do not cause gingivitis if patients are compliant with self-performed plaque control and periodic maintenance. Tooth-supported and/or tooth-retained restorations and their design, fabrication, delivery, and materials have often been associated with plaque retention and loss of attachment. Hypersensitivity reactions can occur to dental materials. Restoration margins placed within the junctional epithelium and supracrestal connective tissue attachment can be associated with inflammation and, potentially, recession. However, the evidence in several of the reviewed areas, especially related to the biologic mechanisms by which these factors affect the periodontium, is not conclusive. This highlights the need for additional well-controlled animal studies to elucidate biologic mechanisms, as well as longitudinal prospective human trials. Adequate periodontal assessment and treatment, appropriate instructions, and motivation in self-performed plaque control and compliance to maintenance protocols appear to be the most important factors to limit or avoid potential negative effects on the periodontium caused by fixed and removable prostheses.
Collapse
Affiliation(s)
- Carlo Ercoli
- Departments of Periodontics and Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Jack G Caton
- Department of Periodontics, Eastman Institute for Oral Health, University of Rochester
| |
Collapse
|
15
|
Ying X, Chen Y, Zhang KL. [Modified tunnel technique applied in the treatment of gingival recessions with non-carious cervical lesion]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:496-500. [PMID: 31721496 DOI: 10.7518/hxkq.2019.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to investigate the clinical effect of modified tunnel technique (MTUN) in the treatment of gingival recession with non-carious cervical lesion (NCCL). METHODS Forty-two teeth with Miller I degree gingival recession were divided into the NCCL group or control group depending on whether NCCL was present. Both groups were treated with MTUN plus subepithelial connective tissue. The periodontal probing depth (PD), gingival recession height (GRH), gingival recession width (GRW), attached gingival width (AGW), and clinical attachment loss (CAL) were recorded before and at 3 and 6 months after operation. The mean root coverage (MRC) at 6 months after operation was calculated and analyzed. A root coverage esthetic scoring system was used to record aesthetic scores. RESULTS GRH, GRW, and CAL of the two groups after surgery were significantly lower than those before surgery, and no significant changes in PD and AGW were observed. The MRC in the NCCL group was 63.40%±28.02%, whereas that in the control group was 67.00%±21.72%; no significant difference between the two groups was found. In terms of aesthetic outcomes, no significant difference between groups was reported. CONCLUSIONS MTUN can effectively improve gingival recession, and the presence of shallow NCCL (≤1 mm) will not affect the surgical effect of MTUN.
Collapse
Affiliation(s)
- Xuan Ying
- Dept. of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| | - Yue Chen
- Dept. of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| | - Kai-Li Zhang
- Dept. of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| |
Collapse
|
16
|
The Additional Effect of Autologous Platelet Concentrates to Coronally Advanced Flap in the Treatment of Gingival Recessions: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2587245. [PMID: 31428630 PMCID: PMC6683801 DOI: 10.1155/2019/2587245] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 07/09/2019] [Indexed: 01/05/2023]
Abstract
Background To improve the efficacy of regenerative treatment for gingival recessions, the autologous platelet concentrates (APCs) combined with coronally advanced flap (CAF) have been investigated. However, few studies systematically assess the complementary effect of APCs in periodontal regeneration. The present study aims to evaluate the additional effect of different types of APCs to CAF in the treatment of gingival recessions. Methods Electronic databases (EMBASE, MEDLINE, and Cochrane Central Register of Controlled Trails) and relevant journals were searched until May 15, 2019. Only randomized controlled trials (RCTs) in English were included. Outcome variables include root coverage (RC), recession depth (RD), clinical attachment level (CAL), keratinized tissue width (KTW), and gingival thickness (GT). Data were analyzed with Revman5.3. The estimate of effect sizes was expressed as the mean differences and the 95% confidence interval. Results 8 RCTs involving 170 patients (328 sites) were included. Our meta-analysis indicated RC, RD, CAL, KTW, and GT were better improved in the CAF plus APCs groups than the CAF alone. The subgroup analyses revealed that platelet-rich fibrin (PRF) brought significant improvement in RC, RD, CAL, and GT. Concentrated growth factors (CGF) lead clinic beneficial in CAL, KTW, and GT. No significant effect of platelet-rich plasma (PRP) could be found in any clinical parameters when combined with CAF. Conclusions PRF could exert additional effect to CAF; the preferred treatment for gingival recessions was considered. Based on the limited studies, it seemed that PRP failed to show any additional effect and it was not suggested for gingival recessions. Given the limited research and high risk of bias, it is still needed to confirm the additional effect of CGF by more high-quality studies.
Collapse
|
17
|
Roman A, Stratul SI, Rusu D, Boariu M, Soanca A, Balazsi R, Suciu M, Moldovan M, Bulboacă AE. Investigations on the adhesion of new composites for restoring cervical lesions using energy dispersive X-ray analysis and scanning electron microscopy. Sci Rep 2019; 9:9853. [PMID: 31285523 PMCID: PMC6614361 DOI: 10.1038/s41598-019-46340-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/25/2019] [Indexed: 11/08/2022] Open
Abstract
Restoration of noncarious cervical lesions with resin composites is one of the treatment options, but the retention of the restorations located at the crown-root junction is still a cause of clinical concern. The aim of this study was to evaluate the adhesive properties of three experimental resin composites and two commercial materials used to restore cavities prepared on extracted teeth as well as to determine the relative elemental composition of these materials. We tested the null hypothesis, which considered that the adhesive behaviours of different resin composites did not differ. The microleakage test using tracers showed that all tested materials exhibited some degree of dentinal microleakage, although they all had good dentinal adhesion. The results failed to reject the null hypothesis. The scanning electron microscopy revealed completely adapted adhesive interfaces underneath the restorations along with well-developed hybrid layers depending on the adhesive system. Energy dispersive X-ray analysis analyses showed that the restorative materials have similar chemical compositions, with some differences between the samples from the same material. The results support the implementation of experimental resins in clinical settings.
Collapse
Affiliation(s)
- Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 15V. Babeş St., 400012, Cluj-Napoca, Romania
| | - Stefan Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 Bulevardul Revolutiei din 1989, 300070, Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 Bulevardul Revolutiei din 1989, 300070, Timisoara, Romania
| | - Marius Boariu
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 Bulevardul Revolutiei din 1989, 300070, Timisoara, Romania
| | - Andrada Soanca
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 15V. Babeş St., 400012, Cluj-Napoca, Romania.
| | - Robert Balazsi
- Department of Psychology, Babes-Bolyai University, 7 Sindicatelor St, 400029, Cluj-Napoca, Romania
| | - Maria Suciu
- Electron Microscopy Integrated Laboratory (LIME), National Institute for Research and Development of Isotopic and Molecular Technologies, INCDTIM, 67-103 Donath St., 400293, Cluj-Napoca, Romania
- Department of Molecular Biology and Biotechnologies, Faculty of Biology and Geology, Babeş-Bolyai University, 5-7 Clinicilor St., 400006, Cluj-Napoca, Romania
| | - Mărioara Moldovan
- Raluca Ripan Institute for Research in Chemistry, Babes-Bolyai University, 30 Fântânele St., 400294, Cluj-Napoca, Romania
| | - Adriana Elena Bulboacă
- Department of Pathophysiology, 4-6 Victor Babeș St., Iuliu Haţieganu University of Medicine and Pharmacy, 15V. Babeş St., 400012, Cluj-Napoca, Romania
| |
Collapse
|
18
|
Clinical evaluation of combined surgical/ restorative treatment of gingival recession-type defects using different restorative materials: A randomized clinical trial. J Dent Sci 2019; 13:20-29. [PMID: 30895090 PMCID: PMC6388842 DOI: 10.1016/j.jds.2017.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 09/17/2017] [Indexed: 11/22/2022] Open
Abstract
Background/purpose An ideal therapeutic procedure for the treatment of gingival recession associated with an NCCL has presented a challenge to clinicians. Various dental materials and surgical approaches have been used to manage gingival recessions associated with NCCLs for the most predictable combined surgical/restorative treatment. The objective of this study was to evaluate the treatment of gingival recessions associated with non-carious cervical lesions (NCCL) using a modified coronally advanced flap (MCAF) in combination with a connective tissue graft (CTG) on restored root surfaces. Materials and methods Twenty-three systemically healthy subjects, who were positive for the presence of three cervical lesions associated with gingival recessions in three different adjacent teeth, were enrolled in the study. The NCCL were each restored prior to surgery by using one of three different materials: nanofilled composite resin (NCR), resin-modified glass ionomer cement (RMGI) or giomer. The gingival recession defects were treated by CTG. Results Inter-group differences were not statistically significant for probing depth (PD), relative recession height (rRH), relative clinical attachment level (rCAL), keratinized tissue width (KTW) or keratinized tissue thickness (KTT) (p > 0.05) among the groups at any time. The mean percentage of defect coverage was 71.18 ± 23.16% for NCR + CTG group; 71.33 ± 22.33% for RMGI + CTG group; and 64.23 ± 20.33% for giomer + CTG group at 1 year postoperatively (p > 0.05). Conclusion The combined surgical/restorative treatments provided successful clinical results. Giomer + CTG may be less effective compared to other groups for treatment of gingival recession associated with NCCL.
Collapse
|
19
|
Santamaria MP, Silveira CA, Mathias IF, Neves FLDS, Santos LM, Jardini MAN, Tatakis DN, Sallum EA, Bresciani E. Treatment of single maxillary gingival recession associated with non‐carious cervical lesion: Randomized clinical trial comparing connective tissue graft alone to graft plus partial restoration. J Clin Periodontol 2018; 45:968-976. [DOI: 10.1111/jcpe.12907] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Mauro Pedrine Santamaria
- Department of PeriodontologyCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
| | - Camila Augusto Silveira
- Department of PeriodontologyCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
| | - Ingrid Fernandes Mathias
- Department of Restorative DentistryCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
- Department of Restorative Dental SciencesCollege of DentistryUniversity of Florida Gainesville Florida
| | - Felipe Lucas da Silva Neves
- Department of PeriodontologyCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
| | - Lúcio Murilo Santos
- Department of PeriodontologyCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
| | - Maria Aparecida Neves Jardini
- Department of PeriodontologyCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
| | - Dimitris N. Tatakis
- Division of PeriodontologyCollege of DentistryThe Ohio State University Columbus Ohio
| | - Enilson Antônio Sallum
- Piracicaba Dental SchoolDepartment of Prosthodontics and PeriodonticsDivision of PeriodonticsUNICAMP ‐ University of Campinas Piracicaba São Paulo Brazil
| | - Eduardo Bresciani
- Department of Restorative DentistryCollege of Dentistry – FOSJCUNESP – São Paulo State University São José dos Campos São Paulo Brazil
| |
Collapse
|
20
|
Does enamel matrix derivative application improve clinical outcomes after semilunar flap surgery? A randomized clinical trial. Clin Oral Investig 2018; 23:879-887. [DOI: 10.1007/s00784-018-2506-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/30/2018] [Indexed: 02/01/2023]
|
21
|
Bertoldi C, Zaffe D, Generali L, Lucchi A, Cortellini P, Monari E. Gingival tissue reaction to direct adhesive restoration: A preliminary study. Oral Dis 2018; 24:1326-1335. [PMID: 29766617 DOI: 10.1111/odi.12893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/26/2018] [Accepted: 05/08/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION It is debated whether composite resin marginal/submarginal direct restoration can be usefully performed without inflammatory consequences. This histological study is the first human analysis aimed to compare, in the same tooth, the gingival tissue close to composite resin restorations with gingival tissue close to hard tissue. METHODS Eight healthy patients with almost a residual strategic tooth needing endodontic therapy, and post-and-core restoration, then indirect prosthetic restoration, were selected. Direct margin relocation with composite resin was necessary to perform endodontic treatment. The crown lengthening with a secondary flap harvested was necessary to perform prosthetic rehabilitation. Three months after marginal relocation, the secondary flap was harvested, embedded in PMMA, 4-μm sectioned, and stained to analyze the inflammation degree. RESULTS All patients completed post-and-core reconstruction and the planned prosthetic therapy, maintaining the stringent hygienic protocol plan. The inflammation level comparison, slightly lower in gingiva close to the teeth (3.62 ± 0.38) than in gingiva close to the composite (3.75 ± 0.26), results in a p-value of 0.11 after Wilcoxon test. CONCLUSIONS Results highlight a minimal, statistically not significant difference in the inflammation degree after margin relocation, conceivably due to patients, teeth and cases selection, together with adopted stringent methodological and supportive measures.
Collapse
Affiliation(s)
- Carlo Bertoldi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Davide Zaffe
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Generali
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea Lucchi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Emanuela Monari
- Department of Laboratory Medicine, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
22
|
Isler SÇ, Ozcan G, Akca G, Kocabas Z. The effects of different restorative materials on periodontopathogens in combined restorative-periodontal treatment. J Appl Oral Sci 2018; 26:e20170154. [PMID: 29451649 PMCID: PMC5815360 DOI: 10.1590/1678-7757-2017-0154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 08/21/2017] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of the study was to evaluate the association between subgingival restorations and the target periodontopathogenic bacteria (Pg, Td and Pi) in subgingival biofilm during one year after combined restorative-periodontal treatment. Material and Methods Seventeen systemically healthy subjects, who were positive for the presence of three cervical lesions associated with gingival recessions in three different adjacent teeth, were included in the study. A total of 51 combined defects were treated with connective tissue graft plus a nanofilled composite resin (NCR+CTG), a resin-modified glass ionemer cement (RMGI+CTG) and a fluoride-releasing resin material with pre-reacted glass (PRG), called giomer (Giomer+CTG). Periodontal clinical measurements and subgingival plaque samples were obtained from all combined defects at baseline and at 6 and 12 months after the surgery. The number of bacteria were evaluated by the real-time polymerase chain reaction (qPCR) method. Results No statistically significant difference in the amount of DNA copies of Pg, Td and Pi was observed in any of the groups at any time points (p>0.05). In addition, there was no statistically significant difference in the amount of DNA copies of the bacteria at baseline and at 6 and 12 months postoperatively, regardless of treatment group (p>0.05). Conclusion This study suggests that subgingivally placed NCR, RMGI and giomer restorations can show similar effects on periodontopathogenic bacteria in the treatment of gingival recessions that are associated with noncarious cervical lesions (NCCLs).
Collapse
Affiliation(s)
- Sila Çagri Isler
- Department of Periodontolog, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Gonen Ozcan
- Department of Periodontolog, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Gülcin Akca
- Department of Medical Microbiolog, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Zahide Kocabas
- Biometry and Genetics Unit, Faculty of Agriculture, Ankara University, Ankara, Turkey
| |
Collapse
|
23
|
Agossa K, Godel G, Dubar M, S Y K, Behin P, Delcourt-Debruyne E. Does Evidence Support a Combined Restorative Surgical Approach for the Treatment of Gingival Recessions Associated With Noncarious Cervical Lesions? J Evid Based Dent Pract 2017; 17:226-238. [PMID: 28865819 DOI: 10.1016/j.jebdp.2017.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 04/01/2017] [Accepted: 04/03/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Gingival recessions are frequently associated with noncarious cervical lesions. Combined restorative surgical approaches have been suggested for the management of these combined defects. The aim of this review was to analyze the current evidence on the effectiveness of these combined restorative surgical approaches. METHODS A systematic review of randomized controlled studies published from January 2006 to June 2016 was performed. RESULTS Ten articles comparing combined restorative surgical approaches to surgery alone were included. Both the procedures showed similar outcomes in term of root coverage but the combined restorative surgical approach achieved better result in the reduction of dentin hypersensitivity. In combined restorative surgical treatments, resin-modified glass ionomers showed better antimicrobial properties but poorer esthetic outcome than resin composites. CONCLUSION Data to support or refute definitely the interest of combined approaches for the treatment of gingival recessions associated with noncarious cervical lesions are limited.
Collapse
Affiliation(s)
- Kevimy Agossa
- Univ. Lille, Inserm, CHU Lille, U1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France; Department of Periodontology, School of Dentistry, University of Lille, Lille, France.
| | | | - Marie Dubar
- Department of Periodontology, Lorraine University, Nancy, France
| | - Kadiatou S Y
- Department of Restorative Dentistry and Endodontics, School of Dentistry, University of Lille, Lille, France
| | - Pascal Behin
- Department of Prosthodontics, School of Dentistry, University of Lille, Lille, France
| | - Elisabeth Delcourt-Debruyne
- Univ. Lille, Inserm, CHU Lille, U1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France; Department of Periodontology, School of Dentistry, University of Lille, Lille, France
| |
Collapse
|