Recobrimento radicular unitário associado a biomateriais: relato de caso
DOI:
https://doi.org/10.70614/wtd9s037Palavras-chave:
Traumatismo dentário, Retração gengival, Enxerto ósseo, Membrana colágenaResumo
A retração gengival, perda de tecido entre gengiva e dente, pode resultar na exposição da raiz. Fatores incluem má posição dentária e higiene inadequada. Cairo et al. (2018) propuseram uma classificação baseada na avaliação do fenótipo, na gravidade da recessão e na presença de lesões cervicais associadas. Várias abordagens terapêuticas, como enxertos ósseos, membranas de colágenos, são empregadas no tratamento da retração gengival. Paciente A.B.P, 37 anos, gênero feminino, compareceu a clínica com a queixa principal “tenho sensibilidade no dente de baixo”. Na avaliação clínica intrabucal constatou a presença de cálculo e nos exames periodontais teve como diagnóstico recessão gengival unitário tipo 2 (RT2) no elemento 41. O objetivo deste relato é descrever a sequência de um caso clínico, em que foi utilizado a técnica cirúrgica de recobrimento radicular com biomaterial de membrana de colágeno absorvível associado a enxerto ósseo sintético no elemento 41. Por fim, o recobrimento unitário da raiz com biomateriais foi bem-sucedido em termos de cicatrização, desconforto pós-operatório e ganho de tecido queratinizado, com regeneração do ponto de vista clínico, melhorando a retração gengival, superando as expectativas do profissional e do paciente.
Downloads
Referências
1. Rafael Junior JC, Siqueira NC, Mazorra PCH, Pfau VJM, Pfau EA. Uso de matriz de colágeno para tratamento de recessão gengival RT1. RSBO. 2021;18(1):165–72.
2. Ozsagir ZB, Saglam E, Sen Yilmaz B, Choukroun J, Tunali M. Injectable platelet-rich fibrin and microneedling for gingival augmentation in thin periodontal phenotype: A randomized controlled clinical trial. J Clin Periodontol. 2020 Apr 1;47(4):489–99.
3. Chambrone L, Salinas Ortega MA, Sukekava F, Rotundo R, Zamira K, Buti J, et al. Root coverage procedures for treating localised and multiple recession‐type defects. Cochrane Database Syst Rev. 2018 Oct 2;2018(10).
4. Vitor GP. Recessão gengival: uma revisão narrativa. Rev Bra Mult. 2019;22(2):178–85.
5. Fragkioudakis I, Tassou D, Sideri M, Vouros I. Prevalance and clinical characteristics of gingival recession in Greek young adults: A cross-sectional study. Clin Exp Dent Res. 2021;7(5):672–8.
6. Naomi R, Ardhani R, Hafiyyah OA, Fauzi MB. Current Insight of Collagen Biomatrix for Gingival Recession: An Evidence-Based Systematic Review. Polymers (Basel). 2020 Sep 1;12(9).
7. Imber JC, Kasaj A. Treatment of gingival recession: when and how? Int Dent J. 2021 Jun 1;71(3):178.
8. Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. J Clin Periodontol. 2018 Jul;38(7):661–6.
9. Mehta V, Kaçani G, Moaleem MMA, Almohammadi AA, Alwafi MM, Mulla AK, et al. Hyaluronic Acid: A New Approach for the Treatment of Gingival Recession—A Systematic Review. Int J Environ Res Public Health. 2022 Nov 1;19(21).
10. Cortellini P, Bissada NF. Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. J Clin Periodontol. 2018 Jun 1;45 Suppl 20:S190–8.
11. Mythri S, Arunkumar S, Hegde S, Rajesh S, Munaz M, Ashwin D. Etiology and occurrence of gingival recession - An epidemiological study. J Indian Soc Periodontol. 2015 Nov 1;19(6):671.
12. Mansouri SS, Moghaddas O, Torabi N, Ghafari K. Vestibular incisional subperiosteal tunnel access versus coronally advanced flap with connective tissue graft for root coverage of Miller’s class I and II gingival recession: A randomized clinical trial. J Adv Periodontol Implant Dent. 2019 Aug 31;11(1):12.
13. Tomina D, Buduru S, Dinu CM, Kui A, Dee C, Cosgarea R, et al. Incidence of malocclusion among young patients with gingival recessions: a cross-sectional observational pilot study. Med. 2021;57(12):1–9.
14. Ucak Turer O, Ozcan M, Alkaya B, Surmeli S, Seydaoglu G, Haytac MC. Clinical evaluation of injectable platelet-rich fibrin with connective tissue graft for the treatment of deep gingival recession defects: A controlled randomized clinical trial. J Clin Periodontol. 2020 Jan 1;47(1):72–80.
15. Agrawal D, Jaiswal P. Injectable platelet rich fibrin (i-PRF): a gem in dentistry. Int J Cur Res Rev. 2020;12(21):25–30.
16. Patra L, Raj SC, Katti N, Mohanty D, Pradhan SS, Tabassum S, et al. Comparative evaluation of effect of injectable platelet-rich fibrin with collagen membrane compared with collagen membrane alone for gingival recession coverage. World J Exp Med. 2022 Jul 7;12(4):68.
17. Tavelli L, McGuire MK, Zucchelli G, Rasperini G, Feinberg SE, Wang HL, et al. Extracellular matrix-based scaffolding technologies for periodontal and peri-implant soft tissue regeneration. J Periodontol. 2020 Jan 1;91(1):17–25.
18. Boháč M, Danišovič Ľ, Koller J, Dragúňová J, Varga I. What happens to an acellular dermal matrix after implantation in the human body? A histological and electron microscopic study. Eur J Histochem. 2018 Jan 1;62(1):1–11.
19. Dubaj JS, Martins TM. Cirurgia plástica periodontal para tratamento de recessão gengival: acompanhamento após um ano . INPerio. 2019;4(4):774–82.
20. Mercado-García J, Rosso P, Gonzalvez-García M, Colina J, Fernández JM. Gummy smile: mercado-rosso classification system and dynamic restructuring with hyaluronic acid. Aesthetic Plast Surg. 2021;45(5):2338.
21. Esposito M, Grusovin MG, Papanikolaou N, Coulthard P, Worthington H V. Enamel matrix derivative (Emdogain®) for periodontal tissue regeneration in intrabony defects. A Cochrane systematic review. Eur J Oral Implantol. 2009;2(4):247–66.
22. Salem S, Salhi L, Seidel L, Lecloux G, Rompen E, Lambert F. Tunnel/Pouch versus Coronally Advanced Flap Combined with a Connective Tissue Graft for the Treatment of Maxillary Gingival Recessions: Four-Year Follow-Up of a Randomized Controlled Trial. J Clin Med. 2020 Aug 1;9(8):1–14.
23. Mahajan R, Khinda P, Shewale A, Ghotra K, Bhasin MT, Bhasin P. Comparative efficacy of placental membrane and HealiguideTM in treatment of gingival recession using guided tissue regeneration. J Indian Soc Periodontol. 2018 Nov 1;22(6):513.
24. Lahham C, Ta’a MA. Clinical comparison between different surgical techniques used to manage advanced gingival recession (Miller’s class III & IV). Heliyon. 2022 Aug 1;8(8):e10132.
25. Kuralt M, Gašperšič R, Fidler A. The precision of gingival recession measurements is increased by an automated curvature analysis method. BMC Oral Health. 2021 Dec 1;21(1).
26. Needleman I, Worthington H V., Giedrys-Leeper E, Tucker R. Guided tissue regeneration for periodontal infra‐bony defects. Cochrane Database Syst Rev. 2019 May 29;2019(5):CD001724.
27. Chan HL, Chun YHP, MacEachern M, Oates TW. Does gingival recession require surgical treatment? Dent Clin North Am. 2015 Oct 1;59(4):981.
28. Panda S, Khijmatgar S, Arbildo-Vega H, Das AC, Kumar M, Das M, et al. Stability of biomaterials used in adjunct to coronally advanced flap: A systematic review and network meta‐analysis. Clin Exp Dent Res. 2022 Feb 1;8(1):421.
29. Jovičić B, Matijević S, Veličković S, Stevanović M, Mišić A, Stanojević S, et al. Effectiveness of Plasma-Rich Fibrin and De-Epithelialized Free Gingival Graft in the Treatment of Gingival Recessions. Medicina (B Aires). 2023 Mar 1;59(3).tic and Investigational Dentistry, v. 6, p. 45-56, 2014.
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2025 Revista Clínica de Odontologia
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
