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Abstract(s)
Introdução: Os enxertos de tecido conjuntivo são frequentemente
utilizados em procedimentos de recobrimento radicular. Sugere-se a técnica de
incisão única, promovendo cicatrização por intenção primária no local dador,
estando descrito que poderá induzir menor morbidade pós-operatória ao
paciente. Outros propõem o enxerto gengival livre, conferindo melhor
visualização do campo operatório e vantagens a nível de espessura gengival.
Objetivo: Comparar o padrão de cicatrização do palato após a recolha de
enxerto de tecido conjuntivo nos tempos pós-operatórios de 3 e 6 meses através
de dois tipos de técnicas de recolha.
Materiais e Métodos: Estudo prospetivo de coorte, num período de 6
meses composto por três tempos de avaliação: dia da cirurgia, 3 meses e 6
meses depois da cirurgia. A amostra compreendeu 19 locais de recolha do palato
lateral: quatro enxertos subepiteliais (SE) removidos através da técnica “single
incision” descrita por Hürzeler MB. & Weng D.; os restantes 15 enxertos
desepitelizados (DE) foram removidos através da técnica descrita por Zucchelli,
G. et al. O protocolo da avaliação realizou-se através de uma análise digital:
efetuaram-se modelos de estudo a cada paciente operado, nos tempos prédefinidos,
sendo os mesmos digitalizados com um scanner intraoral
(DentalWings®). Nos programas informáticos, Geomagic Control X® e Materialise
Magics®, efetuou-se a análise digital tridimensional das áreas intervencionadas.
Resultados: Em relação à técnica SE calculou-se uma alteração média
da espessura e volume de 0,36mm e 77,52mm3, respetivamente, em T1, e, de
-0,10mm e 16,99mm3, respetivamente, em T2. No grupo DE calculou-se uma
alteração média da espessura e volume de -0,26mm e 46,99mm3,
respetivamente em T1, e, -0,25mm e 50,53mm3, respetivamente, em T2.
Conclusões: A recolha de ETC promove alterações a nível dos tecidos
moles do palato duro, podendo ocorrer ganho e/ou perda de volume/espessura;
aparentam não estabilizar nos primeiros 3 meses, ocorrendo alterações
subsequentes. Não existem diferenças significativas entre as técnicas em
estudo. A avaliação digital tridimensional demonstrou possuir um carácter
inovador, permitindo estudar a dinâmica da cicatrização de tecidos moles.
Introduction: Connective tissue grafts are frequently used in root coverage procedures. Some suggest a single incision technique, promoting primary intention healing at the donor site, probably inducing less postoperative morbidity to the patient. Others propose the free gingival graft, having a better view of the surgical site and advantages in gingival thickness. Aim: To compare the healing pattern in the palate following harvesting of connective tissue graft at 3 and 6 months of postoperative by two different harvesting techniques. Materials and Methods: This is a prospective cohort study, over a period of 6 months. Three evaluation times were made - surgery day (T0), 3 months (T1) and 6 months after surgery (T2). The sample included 19 lateral palatal donor sites. Four subepithelial tissue grafts were harvested using the single incision technique by Hürzeler MB. & Weng D. while the remaining 15 de-epithelialized tissue grafts were harvested using the technique by Zucchelli, G. et al. Digital evaluation protocol: Patient’s casts were recorded at T0, T1 and T2. The casts were digitalized by an intra-oral scanner (DentalWings®). In the computer programs, Geomagic Control X® e Materialise Magics®, the three-dimensional digital analysis of the intervened areas was recorded. Results: Regarding to the SE technique mean thickness and volume change was calculated, getting 0.36mm and 77.52mm3, respectively, at T1, and, 0.10mm and 16.99mm3, respectively, at T2. Regarding to the DE group mean thickness and volume change was calculated, getting -0.26mm and 46.99mm3, respectively, at T1, and, -0.25mm and 50.53mm3, respectively, at T2. Conclusions: ETC harvesting promotes hard palate soft tissues changes and volume/thickness gain or loss may occur; tissue stabilization appears not to happen in the first 3 months, with subsequent changes in place. There appears to be a non-significant tendency for the DE technique to produce minor soft tissue changes comparing to the SE technique. The three-dimensional digital evaluation has shown to be innovative, allowing us to study soft tissue healing dynamics.
Introduction: Connective tissue grafts are frequently used in root coverage procedures. Some suggest a single incision technique, promoting primary intention healing at the donor site, probably inducing less postoperative morbidity to the patient. Others propose the free gingival graft, having a better view of the surgical site and advantages in gingival thickness. Aim: To compare the healing pattern in the palate following harvesting of connective tissue graft at 3 and 6 months of postoperative by two different harvesting techniques. Materials and Methods: This is a prospective cohort study, over a period of 6 months. Three evaluation times were made - surgery day (T0), 3 months (T1) and 6 months after surgery (T2). The sample included 19 lateral palatal donor sites. Four subepithelial tissue grafts were harvested using the single incision technique by Hürzeler MB. & Weng D. while the remaining 15 de-epithelialized tissue grafts were harvested using the technique by Zucchelli, G. et al. Digital evaluation protocol: Patient’s casts were recorded at T0, T1 and T2. The casts were digitalized by an intra-oral scanner (DentalWings®). In the computer programs, Geomagic Control X® e Materialise Magics®, the three-dimensional digital analysis of the intervened areas was recorded. Results: Regarding to the SE technique mean thickness and volume change was calculated, getting 0.36mm and 77.52mm3, respectively, at T1, and, 0.10mm and 16.99mm3, respectively, at T2. Regarding to the DE group mean thickness and volume change was calculated, getting -0.26mm and 46.99mm3, respectively, at T1, and, -0.25mm and 50.53mm3, respectively, at T2. Conclusions: ETC harvesting promotes hard palate soft tissues changes and volume/thickness gain or loss may occur; tissue stabilization appears not to happen in the first 3 months, with subsequent changes in place. There appears to be a non-significant tendency for the DE technique to produce minor soft tissue changes comparing to the SE technique. The three-dimensional digital evaluation has shown to be innovative, allowing us to study soft tissue healing dynamics.
Description
Keywords
Cirurgia plástica periodontal Tecido conjuntivo Enxerto de tecido Dinâmica da cicatrização Avaliação volumétrica Periodontal plastic surgery Connective tissue Tissue graft Healing dynamics Volumetric analysis