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Farouk AT, Hassanein OES, Fahmy OI, Elkady AM, ElNahass H. Biological evaluation of indirect restorations in endodontically treated posterior teeth with deeply located proximal margins following deep margin elevation versus surgical crown lengthening: a randomized controlled trial. Clin Oral Investig 2023; 28:24. [PMID: 38147139 DOI: 10.1007/s00784-023-05434-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/20/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE The current clinical trial was conducted to evaluate the effect of proximal indirect restorations in endodontically treated posterior teeth with deeply located margins following deep margin elevation compared to surgical crown lengthening. MATERIAL AND METHODS Deep proximal cavities in endodontically treated posterior teeth were randomly assigned into two groups; deep margin elevation (DME) or crown lengthening (CL). The clinical attachment level (CAL), probing depth (PD), bleeding on probing (BOP), crestal bone level (CBL), and secondary caries were evaluated at the baseline, 1, 3, 6, 9, and 12 months. RESULTS A total of 20 proximal cavities were included in the study; there was no significant difference between the two groups regarding mean CAL values at the baseline and 1 month, while there was a significant difference between the two groups in all other periods. Regarding the PD, there was no statistical significance between the two groups except at 9 and 12 months, where CL showed higher mean PD values than DME. There was no statistically significant difference in BOP or CBL between the two groups. CONCLUSIONS DME and CL are considered clinically successful with favorable biologic responses. CLINICAL RELEVANCE The deep margin elevation approach could provide a more conservative solution when relocating deeply seated cervical margins in a more coronal position. DME reduced the number of visits and time needed for the restoration of endodontically treated teeth. Surgical crown lengthening remains a gold standard procedure in the re-establishment of the supracrestal tissue attachment, especially in cases where cervical margins are beyond the elevation capacity.
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Affiliation(s)
- Ahmed Tarek Farouk
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
- Operative Dentistry Department, Faculty of Dentistry, Misr International University, Cairo, Egypt
| | | | - Ola Ibrahim Fahmy
- Operative Dentistry Department, Faculty of Dentistry, Misr International University, Cairo, Egypt
| | - Ahmed M Elkady
- Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Hani ElNahass
- Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt.
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
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Bardini G, Orrù C, Ideo F, Nagendrababu V, Dummer P, Cotti E. Clinical management of external cervical resorption: A systematic review. AUST ENDOD J 2023; 49:769-787. [PMID: 37702252 DOI: 10.1111/aej.12794] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/14/2023]
Abstract
This review investigated whether any therapeutic options influenced the outcome of treatment for teeth with external cervical resorption. Out of 870 articles identified by an electronic search, 60 clinical case reports and six case series were included. No randomised clinical trials were found. Risk of bias was assessed using Joanna Briggs Institute's tools. External surgical intervention was the preferred method of accessing the lesions. Removal of resorptive tissue was most often achieved mechanically. Bioactive endodontic cements were the preferred materials for restoring teeth. The outcome measures were based on clinical and radiographic parameters. Of the cases included in the review, no specific treatment approach had a superior outcome in relation to Heithersay's classification. Furthermore, due to the absence of randomised clinical trials, and the low level of evidence associated with case reports/case series, it was not possible to define the optimum clinical treatment for external cervical resorption.
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Affiliation(s)
- Giulia Bardini
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Cristiano Orrù
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Francesca Ideo
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Paul Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
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Robaian A, Alqahtani A, Alanazi K, Alanazi A, Almalki M, Aljarad A, Albaijan R, Maawadh A, Sufyan A, Mirza MB. Different Designs of Deep Marginal Elevation and Its Influence on Fracture Resistance of Teeth with Monolith Zirconia Full-Contour Crowns. Medicina (B Aires) 2023; 59:medicina59040661. [PMID: 37109619 PMCID: PMC10144512 DOI: 10.3390/medicina59040661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Background and objectives: Even with the demand for high esthetics, the strength of the material for esthetic applications continues to be important. In this study, monolith zirconia (MZi) crowns fabricated using CAD/CAM were tested for fracture resistance (FR) in teeth with class II cavity designs with varying proximal depths, restored through a deep marginal elevation technique (DME). Materials and Methods: Forty premolars were randomly divided into four groups of ten teeth. In Group A, tooth preparation was conducted and MZi crowns were fabricated. In Group B, mesio-occluso-distal (MOD) cavities were prepared and restored with microhybrid composites before tooth preparation and the fabrication of MZi crowns. In Groups C and D, MOD cavities were prepared, differentiated by the depth of the gingival seat, 2 mm and 4 mm below the cemento-enamel junction (CEJ). Microhybrid composite resin was used for DME on the CEJ and for the restoration of the MOD cavities; beforehand, tooth preparations were conducted and MZi crowns were and cemented using resin cement. The maximum load to fracture (in newtons (N)) and FR (in megapascals (MPa)) were measured using the universal testing machine. Results: The average scores indicate a gradual decrease in the load required to fracture the samples from Groups A to D, with mean values of 3415.61 N, 2494.11 N, 2108.25 N and 1891.95 N, respectively. ANOVA revealed highly significant differences between the groups. Multiple group comparisons using the Tukey HSD post hoc test revealed that Group D had greater DME depths and showed significant differences compared with Group B. Conclusions: FR in teeth decreased when more tooth structure was involved, even with MZi crowns. However, DME up to 2 mm below the CEJ did not negatively influence the FR. Strengthening the DME-treated teeth with MZi crowns could be a reasonable clinical option, as the force required to fracture the samples far exceeded the maximum recorded biting force for posterior teeth.
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Deep Margin Elevation: Current Concepts and Clinical Considerations: A Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101482. [PMID: 36295642 PMCID: PMC9610387 DOI: 10.3390/medicina58101482] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/05/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
Dietschi and Spreafico first proposed deep margin elevation (DME) in 1998 to address the multiple clinical problems associated with sub-gingival margins, where sub-gingival margins will be repositioned coronally using composite resin restorations. Given that dentistry is directing towards conservatism, its use is currently trending. Materials and Methods: a search was performed through PubMed, Scopus, and Google Scholar search engines to obtain relevant articles with no time restriction. Results: With biological width taken into consideration, well-defined and polished sub-gingival restorations are compatible with periodontal health. Marginal integrity in the DME technique seems to be affected by the type of adhesive, restoration, and incremental layering of the restoration. Regarding fracture resistance, DME has no significant effects. Conclusion: The DME technique seems to be a minimally invasive alternative to surgical crown lengthening (SCL) and orthodontic extrusion (OE) with respect to biological width. Well-controlled clinical trials are limited in this field; further long-term follow-up studies emphasizing the periodontal outcomes and prevention of complications are needed.
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Fischer NG, Kobe AC, Dai J, He J, Wang H, Pizarek JA, De Jong DA, Ye Z, Huang S, Aparicio C. Tapping basement membrane motifs: Oral junctional epithelium for surface-mediated soft tissue attachment to prevent failure of percutaneous devices. Acta Biomater 2022; 141:70-88. [PMID: 34971784 PMCID: PMC8898307 DOI: 10.1016/j.actbio.2021.12.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 01/08/2023]
Abstract
Teeth, long-lasting percutaneous organs, feature soft tissue attachment through adhesive structures, hemidesmosomes, in the junctional epithelium basement membrane adjacent to teeth. This soft tissue attachment prevents bacterial infection of the tooth despite the rich - and harsh - microbial composition of the oral cavity. Conversely, millions of percutaneous devices (catheters, dental, and orthopedic implants) fail from infection yearly. Standard of care antibiotic usage fuels antimicrobial resistance and is frequently ineffective. Infection prevention strategies, like for dental implants, have failed in generating durable soft tissue adhesion - like that seen with the tooth - to prevent bacterial colonization at the tissue-device interface. Here, inspired by the impervious natural attachment of the junctional epithelium to teeth, we synthesized four cell adhesion peptide (CAPs) nanocoatings, derived from basement membranes, to promote percutaneous device soft tissue attachment. The two leading nanocoatings upregulated integrin-mediated hemidesmosomes, selectively increased keratinocyte proliferation compared to fibroblasts, which cannot form hemidesmosomes, and expression of junctional epithelium adhesive markers. CAP nanocoatings displayed marked durability under simulated clinical conditions and the top performer CAP nanocoating was validated in a percutaneous implant murine model. Basement membrane CAP nanocoatings, inspired by the tooth and junctional epithelium, may provide an alternative anti-infective strategy for percutaneous devices to mitigate the worldwide threat of antimicrobial resistance. STATEMENT OF SIGNIFICANCE: Prevention and management of medical device infection is a significant healthcare challenge. Overzealous antibiotic use has motivated alternative material innovations to prevent infection. Here, we report implant cell adhesion peptide nanocoatings that mimic a long-lasting, natural "medical device," the tooth, through formation of cell adhesive structures called hemidesmosomes. Such nanocoatings sidestep the use of antimicrobial or antibiotic elements to form a soft-tissue seal around implants. The top performing nanocoatings prompted expression of hemidesmosomes and defensive factors to mimic the tooth and was validated in an animal model. Application of cell adhesion peptide nanocoatings may provide an alternative to preventing, rather that necessarily treating, medical device infection across a range of device indications, like dental implants.
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Affiliation(s)
- Nicholas G Fischer
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States
| | - Alexandra C Kobe
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States
| | - Jinhong Dai
- Institute of Stomatology, School and Hospital of Stomatology, Department of Prosthodontics, Wenzhou Medical University, 373 Xueyuan Xi Road, Wenzhou, Zhejiang 325027, China
| | - Jiahe He
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States
| | - Hongning Wang
- Institute of Stomatology, School and Hospital of Stomatology, Department of Prosthodontics, Wenzhou Medical University, 373 Xueyuan Xi Road, Wenzhou, Zhejiang 325027, China
| | - John A Pizarek
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States; United States Navy Dental Corps, Naval Medical Leader and Professional Development Command, 8955 Wood Road Bethesda, MD 20889, United States
| | - David A De Jong
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States
| | - Zhou Ye
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States
| | - Shengbin Huang
- Institute of Stomatology, School and Hospital of Stomatology, Department of Prosthodontics, Wenzhou Medical University, 373 Xueyuan Xi Road, Wenzhou, Zhejiang 325027, China
| | - Conrado Aparicio
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, Minnesota 55455, United States.
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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.
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谢 成, 廖 阳, 童 方, 方 静, 王 勤, 余 慧. [Efficacy of tunnel technique for treatment of gingival recession of upper adjacent teeth with noncarious cervical defect]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:1680-1685. [PMID: 34916194 PMCID: PMC8685711 DOI: 10.12122/j.issn.1673-4254.2021.11.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To evaluate the efficacy of tunnel technique (TUN) in treatment of teeth with adjacent gingival regression (GR) combined with noncarious cervical lesions (NCCL). METHODS We collected data from 21 patients (79 teeth) undergoing TUN surgery for GR combined with NCCL. According to GR depth (GRD) and lesion depth (LD) of NCCL, the teeth were divided into group 1 with GRD≤3 mm and LD≤1 mm; group 2 with GRD≤3 mm and LD>1mm; group 3 with GRD>3 mm and LD≤1 mm; and group 4 with GRD>3 mm and LD>1 mm. The mean root coverage (MRC) rate, complete root coverage (CRC) rate, keratinized gingival width, and keratinized gingival thickness were compared among the 4 groups after TUN surgery. RESULTS The keratinized gingival width and thickness were significantly improved after the surgery in the 4 groups. When the GRD was below 3 mm, the MRC was not significantly different between group 1 and group 2 (8.55% vs 95.45%, P>0.05); When the GRD was beyond 3 mm, the MRC and CRC rates were both decreased in group 3 and group 4, especially in group 4, where the CRC rate (25%) was significantly lower than those in the other 3 groups (P < 0.01). CONCLUSION In patients with GR combined with NCCL, TUN surgery can obviously improve keratinized gingival width and thickness. GRD has a greater effect on the outcome of root coverage than LD, suggesting that NCCL restoration before TUN surgery may not be necessary. Both GRD and LD should be considered in the evaluation of the clinical efficacy of TUN surgery.
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Affiliation(s)
- 成婕 谢
- />南方医科大学口腔医院//广东省口腔医院,广东 广州 510280Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
| | - 阳阳 廖
- />南方医科大学口腔医院//广东省口腔医院,广东 广州 510280Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
| | - 方丽 童
- />南方医科大学口腔医院//广东省口腔医院,广东 广州 510280Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
| | - 静娴 方
- />南方医科大学口腔医院//广东省口腔医院,广东 广州 510280Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
| | - 勤 王
- />南方医科大学口腔医院//广东省口腔医院,广东 广州 510280Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
| | - 慧敏 余
- />南方医科大学口腔医院//广东省口腔医院,广东 广州 510280Stomatology Hospital, Southern Medical University, Guangzhou 510280, China
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Periodontal response to a tricalcium silicate material or resin composite placed in close contact to the supracrestal tissue attachment: a histomorphometric comparative study. Clin Oral Investig 2021; 25:5743-5753. [PMID: 33855658 DOI: 10.1007/s00784-021-03876-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Subgingival dental restorations and periodontal health have been studied for many years; however, there is a low histological evidence on the behavior of new materials in the supracrestal tissue attachment. The aim of this study is to analyze the periodontal response when a tricalcium silicate material (TSM) or composite margin restorations is placed to 0.5 mm and 1.5 mm from the bone crest with a histomorphometric analysis in dogs. METHODS Nine mongrel dogs were used in this study: four dogs (8 canine teeth) for TSM group, 4 dogs (8 canine teeth) for composite group, and 1 dog (2 canine teeth) with cavities without restorations. Cavity preparation of 2×2×1 mm was created on the buccal aspect of the canines at 0.5 and 1.5 mm of the crestal bone. Cavities were restored with composite and TSM or were left unrestored as control. After 12 weeks of healing, the dogs were euthanized and blocks containing the tooth and soft tissues were processed. RESULTS In all the specimens, the junction epithelium was stablished apical to the tooth preparations. A shorter distance to the bone (0.5 cavity) implies greater apical periodontal migration regardless of the material used. In the TSM groups, the connective tissue height and the distance between bone level and apical margin preparation were greater than those in the composite groups, while the epithelium height was less. However, there were no statistically significant differences comparing TSM and composite groups at either 0.5 mm or 1.5 mm (p > 0.05). CONCLUSION Histologic analysis did not show periodontal reattachment to TSM or composite. In both cases, bone crest migrates apically. For that reason, it is recommended to perform composite restorations at the subgingival level whenever the distance to the bone crest is at least 2 mm. CLINICAL RELEVANCE Both composite and TSM do not achieve reinsertion of the connective tissue in the biological width.
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Kavuncu G, Yilmaz AM, Karademir Yilmaz B, Yilmaz Atali P, Altunok EC, Kuru L, Agrali OB. Cytotoxicity of Different Nano Composite Resins on Human Gingival and Periodontal Ligament Fibroblast Cell Lines: An In Vitro Study. Biomedicines 2020; 8:biomedicines8030048. [PMID: 32121617 PMCID: PMC7148444 DOI: 10.3390/biomedicines8030048] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 12/17/2022] Open
Abstract
The aim of this study is to determine the cytotoxicity of three different nano composite resins (CRs) on human gingival fibroblast (hGF) and periodontal ligament fibroblast (hPDLF) cell lines. These CRs selected were nanohybrid organic monomer-based Admira Fusion (AF), nanohybrid Bis-(acryloyloxymethyl) tricyclo [5.2.1.0.sup.2,6] decane-based Charisma Topaz (CT), and supra nano filled resin-based Estelite Quick Sigma (EQS). MTT assay was performed to assess the cytotoxicity of CRs at 24 h and one week. AF and EQS applied on hGF cells at 24 h and one week demonstrated similar cytotoxic outcomes. Cytotoxicity of CT on hGF cells at one week was higher than 24 h (p = 0.04). Cytotoxicity of CT on hGF cells was higher at 24 h (p = 0.002) and one week (p = 0.009) compared to control. All composites showed higher cytotoxicity on hPDLF cells at one week than the 24 h (AF; p = 0.02, CT; p = 0.02, EQS; p = 0.04). AF and EQS demonstrated lower cytotoxicity on hPDLF cells than the control group at 24 h (AF; p = 0.01, EQS; p = 0.001). CT was found more cytotoxic on hPDLF cells than the control (p = 0.01) and EQS group (p = 0.008) at one week. The cytotoxicity of CRs on hGF and hPDLF cells vary, according to the type of composites, cell types, and exposure time.
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Affiliation(s)
- Gamze Kavuncu
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul 34854, Turkey; (G.K.); (L.K.)
| | - Ayse Mine Yilmaz
- Department of Biochemistry, Faculty of Medicine, Marmara University, Istanbul 34854, Turkey; (A.M.Y.); (B.K.Y.)
- Genetic and Metabolic Diseases Research and Investigation Center, Marmara University, Istanbul 34854, Turkey
| | - Betul Karademir Yilmaz
- Department of Biochemistry, Faculty of Medicine, Marmara University, Istanbul 34854, Turkey; (A.M.Y.); (B.K.Y.)
- Genetic and Metabolic Diseases Research and Investigation Center, Marmara University, Istanbul 34854, Turkey
| | - Pinar Yilmaz Atali
- Department of Restorative Dentistry, Faculty of Dentistry, Marmara University, Istanbul 34854, Turkey;
| | - Elif Cigdem Altunok
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Yeditepe University, Istanbul 34755, Turkey;
| | - Leyla Kuru
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul 34854, Turkey; (G.K.); (L.K.)
| | - Omer Birkan Agrali
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul 34854, Turkey; (G.K.); (L.K.)
- Correspondence: ; Tel.: +90-216-421-16-21
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Novaes AB, Palioto DB. Experimental and clinical studies on plastic periodontal procedures. Periodontol 2000 2019; 79:56-80. [PMID: 30892770 DOI: 10.1111/prd.12247] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We have compiled, in this Periodontology 2000 review, all Latin American literature on experimental and clinical studies of periodontal plastic procedures. The body of literature on this subject has led to a discussion of the features and treatment outcomes of root-coverage procedures. Over time, knowledge on periodontal plastic procedures has become less empirical and more supportive of the clinical management of recession-type defects. Gingival recession etiology, animal studies, free gingival grafts, pedicle flaps (semilunar, laterally positioned, and coronally positioned), and subepithelial connective tissue grafts are extensively reviewed. The use of allografts as an alternative to subepithelial connective tissue grafts, the treatment of multiple gingival recessions, and the rationale for use of guided tissue regeneration and enamel matrix derivative in plastic periodontal procedure is discussed. We also assess how smoking can affect the treatment outcomes in plastic surgery procedures. Minimally invasive procedures are of great value in improving the features of the final tissues. The following aspects identified in this compilation were of great interest: (a) some factors, anatomical in nature, favor the formation of root recessions, but it is the inflammatory process (caused by the presence of biofilm and/or by traumatic toothbrushing) that is responsible for the development of root recessions; and (b) pedicle flap procedures (especially the coronally positioned flap) are extremely versatile and have the most predictable outcome of all root-coverage procedures, especially when combined with subepithelial connective tissue grafting and/or allogeneic grafts. In summary: subepithelial connective tissue grafting is considered as the first option to augment gingival width and thickness, and it may provide better long-term results; the same principles of root-coverage procedures in individual sites appear be used in clinical practice also for multiple-recession type defects; an allograft is an efficient alternative to a subepithelial connective tissue graft and, when it is the treatment option of choice, the use of wide, extended flaps should be considered; because of the superiority of plastic periodontal procedures over guided tissue regeneration and the technical difficulty of the latter, guided tissue regeneration has become obsolete for root-coverage procedures; there is rather a large body of evidence attesting that smoking negatively influences root-coverage procedures, especially subepithelial connective tissue grafts; and minimally invasive techniques may be of great value for improving the results obtained with plastic periodontal procedures, but these techniques need to be better addressed in clinical trials, both in terms of the quality and quantity of the new tissue generated.
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Affiliation(s)
- Arthur Belém Novaes
- Department of Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Daniela Bazan Palioto
- Department of Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Bertoldi C, Monari E, Cortellini P, Generali L, Lucchi A, Spinato S, Zaffe D. Clinical and histological reaction of periodontal tissues to subgingival resin composite restorations. Clin Oral Investig 2019; 24:1001-1011. [PMID: 31286261 DOI: 10.1007/s00784-019-02998-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/28/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To compare the clinical and histological response of supracrestal periodontal tissues to subgingival composite restorations versus natural root surfaces MATERIAL AND METHODS: In 29 subjects with a single tooth requiring subgingival restorations, a deep margin elevation (DME) procedure with composite resin was applied. Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), and focal probing depth (PD) were measured at baseline, before DME, and after 3 months. The distance between the coronal marked (CM) point to the apical margin of the composite reconstruction (AMR), at baseline, and to the tip of the periodontal probe inserted to reach the bottom of the sulcus (APP), 3 months later, was measured. An all-around secondary flap, harvested to ensure the subsequent single-crown prosthetic rehabilitation was histologically processed. The histological inflammation degree was evaluated in areas of gingival tissues adjacent to the composite (group B) and adjacent to the natural surface of each single tooth (group A). RESULTS Significant FMPS, FMBS, and PD decreases were observed (p < 0.05). CM-AMR and CM-APP were significantly different (p < 0.05), suggesting an attachment gain after 3-months. The inflammation level of gingival tissue was similar in groups A and B (p > 0.05). CONCLUSIONS For the first time, this topic was clinically and histologically studied in humans. Subgingival restorations resulted compatible with gingival health, with levels similar to that of untreated root surfaces. CLINICAL RELEVANCE Deep margin elevation procedure produces favorable clinical and histological outcomes allowing a routine utilization in reconstructive dentistry.
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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, Via del Pozzo 71,, 41124, Italy
| | - Emanuela Monari
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Via del Pozzo 71,, 41124, 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, Via del Pozzo 71,, 41124, 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, Via del Pozzo 71,, 41124, Italy
| | | | - Davide Zaffe
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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12
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Dursun E, Güncü GN, Dursun CK, Kiremitçi A, Karabulut E, Akalın FA. Nanofilled and conventional resin-modified glass ionomer fillings combined with connective tissue grafts for treatment of gingival recessions with non-carious cervical lesions. J Oral Sci 2018; 60:344-351. [PMID: 30146534 DOI: 10.2334/josnusd.17-0190] [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] [Indexed: 11/01/2022]
Abstract
The aim of this study was to evaluate the clinical root coverage results of subepithelial connective tissue grafts (SCTG) performed on teeth with gingival recessions and non-carious cervical lesions (NCCLs) that were restored with cervical fillings and compare the results of two different filling materials: resin-modified glass ionomer (RMGIC) and nano-ionomer cements (NIC). A total of 54 teeth with Miller Class I gingival recessions with or without NCCLs in 36 patients (28 females, 8 males) were treated with SCTGs. Cervical lesions were randomly treated with RMGIC or NIC restorations. Periodontal clinical parameters, height of gingival recession (HGR), width of gingival recession (WGR), height of keratinized tissue, and dentin sensitivity were measured at baseline and 3, 6, and 12 months postoperatively. HGR and WGR values were statistically significantly reduced at all time points when compared to baseline values in all groups. There were no statistically significant differences between the groups in any clinical periodontal parameter (P > 0.05). The percentage of root coverage at 12 months was 89.5%, 90.1%, and 96.2% in the RMGIC, NIC, and control groups, respectively. Successful root coverage with connective tissue grafts may be achieved on teeth restored with RMGIC or NIC cervical fillings.
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Affiliation(s)
- Erhan Dursun
- Department of Periodontology, Faculty of Dentistry, Hacettepe University
| | - Güliz N Güncü
- Department of Periodontology, Faculty of Dentistry, Hacettepe University
| | - Ceyda K Dursun
- Department of Periodontology, Faculty of Dentistry, Hacettepe University
| | - Arlin Kiremitçi
- Department of Restorative Dentistry, Faculty of Dentistry, Hacettepe University
| | - Erdem Karabulut
- Department of Biostatistics, Faculty of Medicine, Hacettepe University
| | - Ferda A Akalın
- Department of Periodontology, Faculty of Dentistry, Hacettepe University
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Espona J, Roig E, Durán-Sindreu F, Abella F, Machado M, Roig M. Invasive Cervical Resorption: Clinical Management in the Anterior Zone. J Endod 2018; 44:1749-1754. [PMID: 30243659 DOI: 10.1016/j.joen.2018.07.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 01/04/2023]
Abstract
According to the high number of articles published on invasive cervical resorption (ICR), this pathology, as commonly believed, is a more frequent form of cervical resorption. ICR is often misdiagnosed as internal resorption or caries, which leads to inappropriate treatment and even unnecessary tooth loss. Despite a correct diagnosis, the treatment of this type of hyperplastic invasive external resorption poses a challenge for the clinician. The Heithersay classification and the use of cone-beam computed tomographic imaging have increased our knowledge of the pathology and helped improve its prognosis. Nevertheless, there is no standard protocol for the treatment of this type of lesion. This article proposes a treatment protocol for ICR based on the pattern and location of resorption. Three treatment approaches (internal access, external access, and intentional replantation) are presented through 3 clinical cases.
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Affiliation(s)
- José Espona
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Elena Roig
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Francesc Abella
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Manoel Machado
- Department of Endodontics, Universidade de São Paulo, São Paulo, Brazil
| | - Miguel Roig
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain.
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14
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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
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15
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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.
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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
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Singh P, Shukla S, Singh K. Management of multiple recession defects in esthetic zone using platelet-rich fibrin membrane: A 36-month follow-up case report. J Indian Soc Periodontol 2018; 22:78-83. [PMID: 29568179 PMCID: PMC5855277 DOI: 10.4103/jisp.jisp_308_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A patient undergoing orthodontic treatment presented with multiple recession defects in maxillary anterior region. After thorough clinical examination and assessment, measurements were recorded. Maxillary anterior teeth with recession defects of 3–4 mm were treated with coronally advanced flap and platelet-rich fibrin (PRF) membrane. Regular follow-up was maintained for the patient at 3, 6 , 12, 18, 24, 30, and 36 months. After 36 months, significant root coverage of 100 percent was observed in four defects and 50% coverage in one defect. This shows that PRF membrane along with coronally advanced provides a predictable and significant result for management of recession defects.
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Affiliation(s)
| | - Sagrika Shukla
- Department of Dentistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Kuldeep Singh
- Department of Dentistry, Rabindra Nath Tagore Medical College, Udaipur, Rajasthan, India
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17
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Dablanca-Blanco AB, Blanco-Carrión J, Martín-Biedma B, Varela-Patiño P, Bello-Castro A, Castelo-Baz P. Management of large class II lesions in molars: how to restore and when to perform surgical crown lengthening? Restor Dent Endod 2017; 42:240-252. [PMID: 28808641 PMCID: PMC5553024 DOI: 10.5395/rde.2017.42.3.240] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/03/2017] [Indexed: 11/26/2022] Open
Abstract
The restoration of endodontic tooth is always a challenge for the clinician, not only due to excessive loss of tooth structure but also invasion of the biological width due to large decayed lesions. In this paper, the 7 most common clinical scenarios in molars with class II lesions ever deeper were examined. This includes both the type of restoration (direct or indirect) and the management of the cavity margin, such as the need for deep margin elevation (DME) or crown lengthening. It is necessary to have the DME when the healthy tooth remnant is in the sulcus or at the epithelium level. For caries that reaches the connective tissue or the bone crest, crown lengthening is required. Endocrowns are a good treatment option in the endodontically treated tooth when the loss of structure is advanced.
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Affiliation(s)
- Ana Belén Dablanca-Blanco
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
| | - Juan Blanco-Carrión
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
| | - Benjamín Martín-Biedma
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
| | - Purificación Varela-Patiño
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
| | - Alba Bello-Castro
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
| | - Pablo Castelo-Baz
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
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18
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Thomas B, Gupta K. In vitro biocompatibility of hydroxyapatite-added GIC: An SEM study using human periodontal ligament fibroblasts. J ESTHET RESTOR DENT 2017; 29:435-441. [DOI: 10.1111/jerd.12317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Betsy Thomas
- Department of Periodontics; Faculty of Dentistry, MAHSA University; Kuala Lumpur Malaysia
| | - Kunal Gupta
- Dental Clinic & Research Centre; MLA Bungalows, Jawahar Chowk, Bhopal India
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Santos FR, Storrer CLM, Cunha EJ, Ulbrich LM, Lopez CAV, Deliberador TM. Comparison of conventional and semilunar coronally positioned flap techniques for root coverage in teeth with cervical abrasion restored with pink resin. Clin Cosmet Investig Dent 2017; 9:7-11. [PMID: 28331369 PMCID: PMC5352164 DOI: 10.2147/ccide.s119040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Gingival recession is the most common mucogingival defect, characterized by apical migration of the gingival margin from the cementoenamel junction and root exposure. Several surgical techniques are reported for the treatment of gingival recession. Here we present a comparison of the conventional (coronally advanced flap) and semilunar coronally positioned flap techniques for root coverage in teeth with cervical abrasion restored with pink resin that mimics the color of the gingiva. Although the conventional technique is more predictable, we found that both techniques were effective in achieving satisfactory and esthetic root coverage.
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Affiliation(s)
| | | | | | - Lucienne M Ulbrich
- Department of Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil
| | - Camilo Andress Villabona Lopez
- Department of Dentistry, University of Santo Tomás, Bucaramanga, Santander, Colombia; Department of Implantology, Federal University of Santa Cataria, Florianópolis, Brazil
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20
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Reston EG, Bueno RPR, Closs LQ, Zettermann J. Fifteen-year Clinical Follow-up of Restoration of Extensive Cervical Resorption in a Maxillary Central Incisor. Oper Dent 2017; 42:E55-E58. [DOI: 10.2341/15-131-s] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Internal bleaching in endodontically treated teeth requires care and protection to prevent harm to the periodontal ligament due to peroxide and may result in external root resorption. There is a myriad of treatment options when this occurs, such as monitoring, extraction, and subsequent rehabilitation with implants or fixed prosthodontics. In some cases, such as the one described here, a conservative attempt to maintain the tooth as a single structure can be made by sealing the resorptive defect. In the present case, we show a multidisciplinary approach where orthodontics, periodontics, and restorative dentistry were involved in treating the maxillary right central incisor (#8) of a 65-year-old patient with extensive cervical resorption, whose chief complaint was esthetics. The proposed treatment was extrusion of the tooth followed by curettage and restoration of the defect with glass ionomer cement. The patient has been followed for 15 years with no signs of recurrence, maintenance of periodontal health, and patient satisfaction with the esthetic outcome.
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Affiliation(s)
- EG Reston
- Eduardo G. Reston, DDS, MSD, PhD, Department of Restorative Dentistry, School of Dentistry, Universidade Luterana do Brasil (ULBRA), São José, Canoas, Brazil
| | - RPR Bueno
- Renata P. R. Bueno, DDS, MSD, PhD, Universidade Luterana do Brasil (ULBRA), Esteio, Brazil
| | - LQ Closs
- Luciane Q. Closs, DDS, MSD, PhD, Department of Orthodontics, School of Dentistry, Universidade Luterana do Brasil (ULBRA), São José, Canoas, Brazil
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21
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Michel A, Erber R, Frese C, Gehrig H, Saure D, Mente J. In vitro evaluation of different dental materials used for the treatment of extensive cervical root defects using human periodontal cells. Clin Oral Investig 2016; 21:753-761. [PMID: 27179653 DOI: 10.1007/s00784-016-1830-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 04/17/2016] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Repair materials for extensive cervical root defects may come in direct contact with periodontal tissues. This in vitro study compared the effects of four calcium silicate cements (CSC), one resin-modified glass ionomer cement, and one glass carbomer cement on primary human gingival fibroblasts (HGF), alveolar osteoblasts (HAO), and a human osteoblast cell line (hFOB 1.19). METHODS HGF, HAO, and hFOB were seeded on discoid test specimens. Relative numbers of viable cells were quantitatively assessed after 1 and 24 h for cytotoxicity/adhesion assays and after 4, 24, 48, and 72 h for proliferation assays. Data were statistically analyzed using non-parametric tests (α = 0.05). RESULTS Relative to the control (100 %), CSC allowed for mean numbers of 71-81 % viable HGF and 80-82 % viable HAO. Then, 64 % of HGF and 56 % of HAO were assessed on GC Fuji II LC. Mean numbers of viable cells were 59-64 % HGF and 67-68 % HAO for GCP Glass Fill specimens. Cells exposed to CSC over 24 h remained viable and even increased in number. Both cell types adhered almost equally well to CSC and GC Fuji II LC. GCP Glass Fill continued to decrease cell viability and adhesion. CSC-based materials and GC Fuji II LC allowed for HGF and hFOB proliferation; however, none of the tested materials specifically stimulated cell proliferation. CONCLUSIONS CSC characterized by low cytotoxicity. GC Fuji II LC shows moderate cytotoxic effects. ProRoot MTA, Harvard MTA, Biodentine, EndoSequence putty, and GC Fuji II LC allow HGF and HAO to adhere and HGF and hFOB to proliferate. GCP Glass Fill decreases cell viability, adhesion, and proliferation. CLINICAL RELEVANCE CSC remain the paramount biologic choice for the repair of extensive cervical root defects. GC Fuji II LC might be considered in addition to CSC when the defect comprises supracrestal areas and the restoration requires superior aesthetic and mechanical characteristics.
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Affiliation(s)
- Annemarie Michel
- Clinic for Oral, Dental and Maxillofacial Diseases, Department of Conservative Dentistry, Division of Endodontics and Dental Traumatology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Ralf Erber
- Clinic for Oral, Dental and Maxillofacial Diseases, Department of Orthodontics, University Hospital Heidelberg, Heidelberg, Germany
| | - Cornelia Frese
- Clinic for Oral, Dental and Maxillofacial Diseases, Department of Conservative Dentistry, Division of Preventive and Restorative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Holger Gehrig
- Clinic for Oral, Dental and Maxillofacial Diseases, Department of Conservative Dentistry, Division of Endodontics and Dental Traumatology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Daniel Saure
- Institute of Medical Biometry and Informatics, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - Johannes Mente
- Clinic for Oral, Dental and Maxillofacial Diseases, Department of Conservative Dentistry, Division of Endodontics and Dental Traumatology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
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Yang S, Lee H, Jin SH. A combined approach to non-carious cervical lesions associated with gingival recession. Restor Dent Endod 2016; 41:218-24. [PMID: 27508164 PMCID: PMC4977353 DOI: 10.5395/rde.2016.41.3.218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/17/2016] [Indexed: 11/13/2022] Open
Abstract
Non-carious cervical lesions (NCCLs) with gingival recession require specific consideration on both aspects of hard and soft tissue lesion. In the restorative aspect, careful finishing and polishing of the restorations prior to mucogingival surgery is the critical factor contributing to success. Regarding surgery, assessment of the configuration of the lesion and the choice of surgical technique are important factors. The precise diagnosis and the choice of the proper treatment procedure should be made on the basis of both restorative and surgical considerations to ensure the successful treatment of NCCLs.
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Affiliation(s)
- SungEun Yang
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - HyeJin Lee
- Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Ho Jin
- Department of Periodontology, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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23
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Santamaria MP, Queiroz LA, Mathias IF, Neves FLDS, Silveira CA, Bresciani E, Jardini MAN, Sallum EA. Resin composite plus connective tissue graft to treat single maxillary gingival recession associated with non-carious cervical lesion: randomized clinical trial. J Clin Periodontol 2016; 43:461-8. [DOI: 10.1111/jcpe.12524] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Mauro Pedrine Santamaria
- Department of Periodontology; College of Dentistry - FOSJC; UNESP - State University of São Paulo; São José dos Campos SP Brazil
| | - Lucas Araújo Queiroz
- Department of Prosthodontics and Periodontics; Division of Periodontics; Piracicaba Dental School; UNICAMP - University of Campinas; Piracicaba SP Brazil
| | - Ingrid Fernandes Mathias
- Department of Restorative Dentistry; College of Dentistry - FOSJC; UNESP - State University of São Paulo; São José dos Campos SP Brazil
| | - Felipe Lucas da Silva Neves
- Department of Periodontology; College of Dentistry - FOSJC; UNESP - State University of São Paulo; São José dos Campos SP Brazil
| | - Camila Augusto Silveira
- Department of Periodontology; College of Dentistry - FOSJC; UNESP - State University of São Paulo; São José dos Campos SP Brazil
| | - Eduardo Bresciani
- Department of Restorative Dentistry; College of Dentistry - FOSJC; UNESP - State University of São Paulo; São José dos Campos SP Brazil
| | - Maria Aparecida Neves Jardini
- Department of Periodontology; College of Dentistry - FOSJC; UNESP - State University of São Paulo; São José dos Campos SP Brazil
| | - Enilson Antônio Sallum
- Department of Prosthodontics and Periodontics; Division of Periodontics; Piracicaba Dental School; UNICAMP - University of Campinas; Piracicaba SP Brazil
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24
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Kilic D, Kesim S, Liman N, Sumer Z, Ozturk A. In VitroComparison of the Effects of Dental Filling Materials on Mouse Fibroblasts. BIOTECHNOL BIOTEC EQ 2014. [DOI: 10.5504/bbeq.2012.0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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25
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Zuhr O, Bäumer D, Hürzeler M. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol 2014; 41 Suppl 15:S123-42. [DOI: 10.1111/jcpe.12185] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/07/2013] [Accepted: 10/16/2013] [Indexed: 01/27/2023]
Affiliation(s)
- Otto Zuhr
- Private Practice Hürzeler/Zuhr; Munich Germany
- Department of Periodontology; Centre for Dental, Oral, and Maxillofacial Medicine (Carolinum); Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
| | | | - Markus Hürzeler
- Private Practice Hürzeler/Zuhr; Munich Germany
- Department of Operative Dentistry and Periodontology; University Dental School; University of Freiburg; Freiburg Germany
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26
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Petersilka G. Periodontal healing of a horizontal root fracture: a case report with a two-year follow-up. Oper Dent 2009; 34:109-13. [PMID: 19192845 DOI: 10.2341/08-27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND For traumatized teeth exhibiting crown-root fractures, there is a growing body of evidence that re-fastening the coronal part may result in successful treatment. However, data on the long-term impact of these bonding procedures on the periodontium are scarce. A case report of a young female patient presenting with an isogingivally- and horizontally-fractured lower incisor with a two-year follow-up is presented. METHODS The tooth fragment was reattached to the remaining root using an adhesive technique after flap elevation and endodontic therapy. No attempt was made to splint the coronal fragment to the neighboring teeth. RESULTS Despite the subgingival location of the bonding surface, uneventful periodontal healing was clinically monitored during the observation period. The coronal fragment was retained successfully for a period of more than two years. CONCLUSIONS Even for tooth fractures below the gingival margin, the combined approach of surgery and adhesive techniques can be used successfully to restore a severely traumatized tooth.
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Affiliation(s)
- Gregor Petersilka
- Department of Periodontology, Westphalian Wilhelm University Muenster, Würzburg, Germany.
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