Treatment of class II furcation defects with autogenous bone graft associated with Bichat’s fat pad: case report

The periodontal treatment of teeth with furcation defect is clinically challenging. In cases of class II furcation defects, the regenerative surgery shows low morbidity and good prognosis when correctly indicated. The aim of the presentstudy is to report a treatment option for class II furcation defect through autogenous bone graft associated with the Bichat’s fat pad. Case report: A 59-year-old female patient was diagnosed with class II furcation defect in the left mandibular first molar. The treatment comprised surgical reconstruction of the defect with a combination of maxillary tuberosity bone graft and Bichat’s fat pad. The clinical and radiographic follow-up of 180 days showed bone formation inthe furcation area and absence of probing depth. Conclusion: An association of autogenous graft form the maxillary tuberosity with a Bichat’s fat pad proved to be a safe, low cost, and effective therapy for the regenerative treatment of class II furcation.The periodontal treatment of teeth with furcation defect is clinically challenging. In cases of class II furcation defects, the regenerative surgery shows low morbidity and good prognosis when correctly indicated. The aim of the presentstudy is to report a treatment option for class II furcation defect through autogenous bone graft associated with the Bichat’s fat pad. Case report: A 59-year-old female patient was diagnosed with class II furcation defect in the left mandibular first molar. The treatment comprised surgical reconstruction of the defect with a combination of maxillary tuberosity bone graft and Bichat’s fat pad. The clinical and radiographic follow-up of 180 days showed bone formation inthe furcation area and absence of probing depth. Conclusion: An association of autogenous graft form the maxillary tuberosity with a Bichat’s fat pad proved to be a safe, low cost, and effective therapy for the regenerative treatment of class II furcation

Effect of the use of different periodontal curettes on the topography and roughness of root surface

Periodontal scaling is the treatment approach most used to remove dental calculus, plaque, and altered cementum from root surface. During root decontamination, the instruments used leave the root rougher and more irregular. Objective: To verify the root surface after mechanical scaling with different Gracey curettes steel through SEM and superficial roughness analyses. Material and methods: Twelve teeth were embedded in acrylic resin. The teeth were instrumented with new Gracey curettes Gracey 5/6 from different brands. The groups (n=2) were divided into: control, no instrumentation (GC); carbon steel (CSN); stainless steel Neumar (SSN); stainless steel Millenium (SSM); premium steel Neumar (PSN); Hu-Friedy (HF). An area measuring 3 x 3 mm2was marked on the distal surface of the root to guide the Reading of the root topography on SEM and rugosimeter. The data were analyzed by a single examiner previously calibrated. SEM analysis was based on scores of the root surface smoothness after scaling. We analyzed the parameters of mean roughness (Ra) and mean roughness deepness (Rz). SEM data were submitted to statistical analysis through Fisher’s exact test (p < 0.002) and roughness data by Anova followed by Student t test. Results: The quality of the active surface of the curette demonstrated by SEM and roughness analyses that it can exert difference in the result regarding to the homogeneity produced after the scaling of root surface. Group SSM demonstrated a homogenous root surface (score 0) in SEM and better smoothness in rugosimeter analysis. Conclusion: According to com the methodology used, the group of curettes that provided better smoothness of root surface after scaling was SSM

Tratamento de pigmentações melânicas com instrumentos rotatórios e lâmina de bisturi Treatment of melanic pigmentations with rotary instruments and scalpel blade

Introduction: Oral pigmentary lesions may have different clinical characteristics, ranging from physiological pigmentation, such as melanin spots, to something more serious, such as malignant melanoma. Due to the great variety of pigmented lesions, the treatments are varied and individualized. Objective: This clinical case reports a case of melanocytic removal through a surgical technique that associates rotary instruments and scalpel blade. Case report: A 45-year-old patient, melanoderma, sought care at the Positivo University, complaining about the dark spots visible on his gum, and the discomfort they caused him when smiling. After the clinical examination, the presence of melanocytic pigmentation was diagnosed and the proposed treatment was surgical removal of spots with a drill and scalpel blade. In the immediate postoperative period, the patient presented good healing and reported only mild burning in the first three days. After 60 days, the gingiva was healed, with no relapsing spots. Conclusion: The technique chosen was effective because it presented adequate healing and absence of relapse of the pigmentation in the postoperative follow-upIntroduction: Oral pigmentary lesions may have different clinical characteristics, ranging from physiological pigmentation, such as melanin spots, to something more serious, such as malignant melanoma. Due to the great variety of pigmented lesions, the treatments are varied and individualized. Objective: This clinical case reports a case of melanocytic removal through a surgical technique that associates rotary instruments and scalpel blade. Case report: A 45-year-old patient, melanoderma, sought care at the Positivo University, complaining about the dark spots visible on his gum, and the discomfort they caused him when smiling. After the clinical examination, the presence of melanocytic pigmentation was diagnosed and the proposed treatment was surgical removal of spots with a drill and scalpel blade. In the immediate postoperative period, the patient presented good healing and reported only mild burning in the first three days. After 60 days, the gingiva was healed, with no relapsing spots. Conclusion: The technique chosen was effective because it presented adequate healing and absence of relapse of the pigmentation in the postoperative follow-u

Treatment of gummy smile: Gingival recontouring with the containment of the elevator muscle of the upper lip and wing of nose. A surgery innovation technique

The containment of the elevator muscle of the upper lip and wing of nose was used for the treatment of patients with gummy smile. This technique had corrected esthetic alterations of smile, reducing the upper lip elevation, which results in a smaller gingival display. An upper lip lengthening as well as a reduction in the upper lip shortening when the patient smiled could be observed. The high smile line was corrected without compromising the labial harmony. This study presents an innovative and effective therapeutic option to obtain a natural and harmonious smile. The patient expressed a high degree of satisfaction

The use of the digital smile design concept as an auxiliary tool in periodontal plastic surgery

Periodontal surgery associated with prior waxing, mock-up, and the use of digital tools to design the smile is the current trend of reverse planning in periodontal plastic surgery. The objective of this study is to report a surgical resolution of the gummy smile using a prior esthetic design with the use of digital tools. A digital smile design and mock-up were used for performing gingival recontouring surgery. The relationship between the facial and dental measures and the incisal plane with the horizontal facial plane of reference were evaluated. The relative dental height x width was measured, and the dental contour drawing was inserted. Complementary lines are drawn such as the gingival zenith, joining lines of the gingival and incisal battlements. The periodontal esthetic was improved according to the established design digital smile pattern. These results demonstrate the importance of surgical techniques and are well accepted by patients and are easy to perform for the professional. When properly planned, they provide the desired expectations. Periodontal Surgical procedures associated with the design digital smile facilitate the communication between the patient and the professional. It is, therefore, essential to demonstrate the reverse planning of the smile and periodontal parameters with approval by the patient to solve the esthetic problem