You are currently viewing Uso de matriz dérmica acelular xenógena em recessão gengival unitária: relato de caso com um ano de acompanhamento

Uso de matriz dérmica acelular xenógena em recessão gengival unitária: relato de caso com um ano de acompanhamento

Relato de caso apresenta o tratamento de uma recessão gengival unitária com o uso de matriz dérmica acelular xenógena associado à técnica de retalho posicionado coronariamente.

AUTORES

Laís Fernanda Ferreira Ferraz
Mestra e doutoranda na área de Periodontia do programa de Biopatologia Bucal – ICT/Unesp.
Orcid: 0000-0003-4486-6335.

Manuela Maria Viana Miguel
Mestra e doutoranda na área de Periodontia do programa de Biopatologia Bucal – ICT/Unesp.
Orcid: 0000-0003-4828-3487.

Amanda Rossato
Mestra e doutoranda na área de Periodontia do programa de Biopatologia Bucal – ICT/Unesp.
Orcid: 0000-0001-9354-9446.

Manuela Bafini Fonseca
Mestra em Odontologia Restauradora e doutora em Periodontia – ICT/Unesp.
Orcid: 0000-0001-9540-7388.

Cristhian Reynaldo Gomez Bautista
Mestre em Patologia e doutor em Periodontia do programa de Biopatologia Bucal – ICT/Unesp.
Orcid: 0000-0002-1732-0313.

Ingrid Fernandes Mathias-Santamaria
Professora colaboradora na área de Periodontia do programa de Biopatologia Bucal – ICT/Unesp.
Orcid: 0000-0003-2518-0135.

Mauro Pedrine Santamaria
Professor livre-docente na disciplina de Periodontia e do programa de Biopatologia Bucal – ICT/Unesp.
Orcid: 0000-0001-9468-0729.

RESUMO

O objetivo do presente relato de caso foi apresentar o tratamento de uma recessão gengival unitária com o uso de matriz dérmica acelular xenógena (XDM) associado à técnica de retalho posicionado coronariamente (CAF). O paciente procurou atendimento odontológico devido à insatisfação estética com o dente canino superior esquerdo, que apresentava uma recessão gengival RT1 de 3,25 mm de altura e ligeira lesão cervical não cariosa (LCNC) do tipo B+, comprometendo menos de 0,25 mm do esmalte. O procedimento cirúrgico foi realizado através da técnica CAF associada ao uso de XDM, de acordo com as instruções do fabricante. O paciente recebeu os devidos cuidados pós-operatórios e foi acompanhado regularmente para manutenção dos cuidados bucais posteriores. As medidas clínicas foram realizadas novamente após seis meses e um ano da terapia cirúrgica. Após um ano de acompanhamento, concluiu-se que a associação entre CAF e XDM proporcionou recobrimento radicular completo e resultados estáveis dentro do período observado.

Palavras-chave – Recessão gengival; Xenoenxertos.

ABSTRACT

The aim of the present case report was to present the treatment of a single gingival recession with xenogeneic acelular dermal matrix (XDM) associated with coronary positioned flap technique (CAF). The patient sought dental care due to esthetics complaints related to upper left canine, which had presented RT1 gingival recession with 3,5 mm of height and B+ non-carious cervical lesion associated affecting less than 0,25 mm of enamel. Root coverage procedure was performed by means CAF associated with XDM following manufacture’s instruction. The patient received adequate postoperative care and was regularly scheduled for supportive care. Clinical measurements were performed at baseline, 6-months, and 1-year of follow-up. After 1 year of follow-up, it could be concluded that the association between CAF and XDM was able to provide complete root coverage and stable outcomes within the observed time period.

Key words – Gingival recession; Heterografts.

Recebido em mar/2020
Aprovado em mai/2020

Referências

  1. Pini Prato GP. Mucogingival deformities. Ann Periodontol 1999;4(1):98-101.
  2. Pini-Prato G, Franceschi D, Cairo F, Nieri M, Rotundo R. Classification of dental surface defects in areas of gingival recession. J Periodontol 2010;81(6):885-90.
  3. Wang HL, Modarressi M, Fu JH. Utilizing collagen membranes for guided tissue regeneration-based root coverage. Periodontol 2000 2012;59(1):140-57.
  4. Santamaria MP, Silveira CA, Mathias IF, Neves FLDS, Dos Santos LM, Jardini MAN et al. 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(8):968-76.
  5. Buti J, Baccini M, Nieri M, La Marca M, Pini-Prato GP. Bayesian network meta-analysis of root coverage procedures: ranking efficacy and identification of best treatment. J Clin Periodontol 2013;40(4):372-86.
  6. Tonetti M S, Jepsen S. Clinical efficacy of periodontal plastic surgery procedures: consensus report of Group 2 of the 10th European Workshop on Periodontology. J Clin Periodontol 2014;41(suppl.15):36-43.
  7. Chambrone L, Tatakis DN. Periodontal soft tissue root coverage procedures: a systematic review from the AAP Regeneration Workshop. J Periodontol 2015;86(suppl.2):8-51.
  8. Wessel JR, Tatakis DN. Patient outcomes following subepithelial connective tissue graft and free gingival graft procedures. J Periodontol 2008;79(3):425-30.
  9. Moreira ARO, Santamaria MP, Silvério KG, Casati MZ, Nociti Junior FH, Sculean A et al. Coronally advanced flap with or without porcine collagen matrix for root coverage: a randomized clinical trial. Clin Oral Investig 2016;20(9):2539-49.
  10. Sangiorgio JPM, Neves FLS, dos Santos MR, França-Grohmann IL, Casarin RCV, Casati MZ et al. Xenogenous collagen matrix and/or enamel matrix derivative for treatment of localized gingival recessions: a randomized clinical trial. Part I: clinical outcomes. J Periodontol 2017;88(12):1309-18.
  11. Pabst AM, Happe A, Callaway A, Ziebart T, Stratul SI, Ackermann M et al. In vitro and in vivo characterization of porcine acellular dermal matrix for gingival augmentation procedures. J Periodontal Res 2014;49(3):371-81.
  12. McGuire MK, Scheyer ET, Schupbach PA. Prospective case-controlled study evaluating the use of enamel matrix derivative on human buccal recession defects: a human histologic examination. J Periodontol 2016;87(6):645-53.
  13. Park JS, Pabst AM, Ackermann M, Moergel M, Jung J, Kasaj A. Biofunctionalization of porcine-derived collagen matrix using enamel matrix derivative and platelet-rich fibrin: influence on mature endothelial cell characteristics in vitro. Clin Oral Investig 2018;22(2):909‐17.
  14. Ayub LG, Ramos UD, Reino DM, Grisi MFM, Taba Jr. M, Souza SLS et al. A randomized comparative clinical study of two surgical procedures to improve root coverage with the acellular dermal matrix graft. J Clin Periodontol 2012;39(9):871-8.
  15. Aichelmann-Reidy ME, Yukna RA, Evans GH, Nasr HF, Mayer ET. Clinical evaluation of acellular allograft dermis for the treatment of human gingival recession. J Periodontol 2001;72(8):998-1005.
  16. 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 2011;38(7):661-6.
  17. De Sanctis M, Zucchelli G. Coronally advanced flap: a modified surgical approach for isolated recession type defects. Three-year results. J Clin Periodontol 2007;34(3):262-8.
  18. Cardaropoli D, Tamagnone L, Roffredo A, Gaveglio L. Treatment of gingival recession defects using coronally advanced flap with a porcine collagen matrix compared to coronally advanced flap with connective tissue graft: a randomized controlled clinical trial. J Periodontol 2012;83(3):321-8.
  19. Cairo F, Nieri M, Pagliaro U. Efficacy of periodontal plastic surgery procedures in the treatment of localized facial gingival recessions. A systematic review. J Clin Periodontol 2014;41(suppl.15):S44-62.
  20. Cieślik-Wegemund M, Wierucka-Młynarczyk B, Tanasiewicz M, Gilowski Ł. Tunnel technique with collagen matrix compared with connective tissue graft for treatment of periodontal recession: a randomized clinical trial. J Periodontol 2016;87(12):1436-43.
  21. Pietruska M, Skurska A, Podlewski Ł, Milewski R, Pietruski J. Clinical evaluation of Miller class I and II recessions treatment with the use of modified coronally advanced tunnel technique with either collagen matrix or subepithelial connective tissue graft: a randomized clinical study. J Clin Periodontol 2019;46(1):86-95.
  22. Jepsen K, Stefanini M, Sanz M, Zucchelli G, Jepsen S. Long-term stability of root coverage by coronally advanced flap procedures. J Periodontol 2017;88(7):626-33.
  23. Vignoletti F, Nuñez J, de Sanctis F, Lopez M, Caffesse R, Sanz M. Healing of a xenogeneic collagen matrix for keratinized tissue augmentation. Clin Oral Implants Res 2015;26(5):545-52.
  24. Jepsen K, Jepsen S, Zucchelli G, Stefanini M, de Sanctis M, Baldini N et al. Treatment of gingival recession defects with a coronally advanced flap and a xenogeneic collagen matrix: a multicenter randomized clinical trial. J Clin Periodontol 2013;40(1):82-9.
  25. Rebele SF, Zuhr O, Schneider D, Jung RE, Hürzeler MB. Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: a RCT using 3D digital measuring methods. Part II. Volumetric studies on healing dynamics and gingival dimensions. J Clin Periodontol 2014;41(6):593-603.
Tags: , , , , ,