Avaliação clínica do uso de enxerto de cimento ósseo para o tratamento do sorriso gengival

• Autor(a) principal: Carvalho, Alexandre Leite
• Data de Publicação: 2016
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/9458
• topic: Cimento ósseo; Aumento de coroa; Sorriso; Estética dental; Lábio; Crown lengthening; Smile; Dental aesthetics; Lip; Bone cements; CIENCIAS DA SAUDE::ODONTOLOGIA

This study aimed to evaluate the clinical results of bone cement graft technique in patients who underwent the treatment of gummy smile regarding to gingival and alveolar mucosa health, smile characteristics and possible correlations with subnasal depression maxilla (DSM) and the thickness of the graft. Fifteen patients, feminine gender, 38,6 (+-11,2) years old, and 63,1 (+-23,5) months after surgery, were provinient from a private dental clinic, which were collected initial photographs of the maximum spontaneous smile previous to surgery. Clinical examination was performed to evaluate probing depth (PS), bleeding on probing (SS) and obtain final photographs of the maximum spontaneous smile after surgery. The initial and final photographs were submitted to metric analysis using ImageJ software to measure gingival display (EG), crown length (CC), vermilion length of the upper lip (CVLS) and change the position of the upper lip (APLS). The graft thickness (EE) and the DSM depth were measured through cephalometric analysis in lateral radiograph image after surgery. Paired t test was used to compare EG, CC and initial and final CVLS, and Pearson correlation test was used to correlate: initial EG with the depth of DSM; change (final - initial) of EG and CVLS and the APLS with EE. All statistical tests were performed at a significance level of 5%. Changes in alveolar mucosa and gingival health were not verified (PS = 2.3 + - 0.5 mm; SS = 13.1 + - 9.8%). There were statistical significant differences between initial EG (4.5 + - 1.6 mm) and final (2.5 + - 1.4 mm) (p = 0.001), initial CC (8.9 + - 1.0 mm) and final ( 9.4 + - 0.9 mm) (p = 0.003). CVLS initial (5.0 + - 1.2 mm) and final (5.5 + - 1.2 mm) showed no significant differences (p = 0.07). Significant correlation was observed only for changing the CVLS (11.5 + - 21.8%) with the EE in percentage (87.9 + - 16.7%) (r = 0.79; p = 0.01). It can be concluded that the bone cement grafting, regardless of its thickness, promoted a reduction of 44.9% gingival display. Of this, 32.6% was attributed to APLS without changes in gingival health and alveolar mucosa after a median follow-up period of 5 years and 3 months.