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Abordagens cirúrgicas e não cirúrgicas para a reconstrução de papilas

RESUMO

Objetivo: fazer uma revisão de literatura sobre as técnicas cirúrgicas e não cirúrgicas utilizadas para recuperar a papila interdental. Material e métodos: uma busca eletrônica foi realizada no site PubMed/MEDLINE e Scopus combinando as palavras-chave “interdental papilla”, “reconstruction”, com buscas adicionais para “hyaluronic acid”, “surgical treatment”, “orthodontic”. Resultados: das referências inicialmente recuperadas, apenas 13 foram selecionadas dentro de três propostas: 1) cirurgia com enxerto de tecido conjuntivo (seis artigos); 2) ácido hialurônico (quatro estudos); e 3) tratamento ortodôntico (três estudos). O tempo de acompanhamento das técnicas cirúrgicas foi de quatro anos e das técnicas não cirúrgicas foi de dois anos. Não houve superioridade de um tratamento em relação ao outro. Conclusão: a reconstrução da papila interdentária permanece um grande desafio na Periodontia. Diante da evidência atual, não apenas relatos de técnicas cirúrgicas e não cirúrgicas para papila, mas um número maior de ensaios clínicos randomizados com maior tempo de acompanhamento serão necessários.

Palavras-chave – Papila interdentária; Ácido hialurônico; Ortodontia; Revisão da literatura.

ABSTRACT

Objective: to perform a literature review on the use of surgical and non surgical techniques to reconstruct the interdental papilla. Material and methods: an electronic search at the PubMed/MEDLINE and Scopus sites was made combining the keywords “interdental papilla” , “reconstruction”, with additional searches for “hyaluronic acid”, “surgical treatment”, “orthodontic”. Results: from the initially retrieved references, only 13 were selected within three aspects: 1) connective tissue surgery (6 studies); 2) hyaluronic acid (4 studies); and 3) orthodontic treatment (3 studies). The follow-up times for surgical and non surgical techniques were 4 and 2 years, respectively. No superior results were demonstrated among all three tested proposals. Conclusion: papillary reconstruction still remains a great challenge in Periodontics. In light of the aforementioned results, not only surgical and non-surgical reports are necessary, but also more RCTs with longer follow-up times.

Key words – Interdental papilla; Hyaluronic acid; Orthodontics; Literature review.

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