ObjectiveThe purpose of this study was to perform a radiographic follow-up evaluation after a 12-month healing period, following crown lengthening surgery.Material and methodsTwenty-three periodontally healthy subjects (mean age 32.5 years) that required crown lengthening surgery in premolars were recruited. In a total of 30 premolars, full thickness flaps, osseous resection, and flap suturing were performed. The restorative margin was defined in the pre-surgical phase and maintained unaltered during the healing period, serving as a reference point. Standardized bitewing radiographs were taken before and after osseous reduction, and at 2, 3, 6, and 12-month healing periods.ResultsIntact lamina dura was observed at both mesial and distal alveolar crests only from the 3rd month. At 12-months, all alveolar crests presented lamina dura. The overall mean distance from the restorative margin to the alveolar crest achieved after osseous resection was 3.28±0.87 mm at mesial and 2.81±0.51 mm at distal sites. No significant radiographic changes in the bone crest were observed during a 12-month healing period.ConclusionThe findings of this study suggest that the radiographic proximal bone level observed on bitewing radiographs following crown lengthening surgery can be used as a reference to predict the future level of the healed alveolar crest.

Blood glucose levels and hemodynamic parameters in type 2 diabetic patients after use of articaine 4% with epinephrine (1:100.000 and 1:200.000) in periodontal surgeries The present study compared the effect of articaine 4% associated with epinephrine in two different concentrations, 1:100.000(A100) and 1:200.000(A200), in periodontal surgeries performed in diabetic patients. We analyze hemodynamic parameters, blood glucose concentration, onset and duration of anesthetic action on soft tissues, intraoperative bleeding and wound healing. Eighteen volunteers, age range 40 to 65 years, with similar periodontal disease and conditions, were separate in two groups, type 2 diabetes mellitus (DM, 8 volunteers) or with no diabetes mellitus (Non DM, 10 volunteers). They´re submitted to a matched bilateral periodontal surgery in maxilla, under local anesthesia with either A100 or A200, in a double blind, randomized, crossed manner. The duration of surgery was the same for all groups, with A100 and A200 being equally effective for periodontal surgeries. Identical volumes of both anesthetic solutions were used (1 cartridge:1,8ml) in all surgeries. The anesthetic latency was similar in diabetics or non-diabetics for both epinephrine concentration. In diabetic patients the anesthetic duration was increased regardless the epinephrine concentration. Intraoperative bleeding only increased in diabetic patients with A200 during incision phase. The duration of postoperative analgesia was excellent, reflecting by a low intake of postoperative medications (paracetamol). Wound healing was relatively normal for all volunteers regardless the local anesthetic employed or presence of diabetes. The transient changes in blood pressure or hart hate were not clinically significant but the diabetic patients have some tendency to increase their blood pressure in some surgical phases. In diabetic subjects, blood glucose have no increase throughout surgical phases, regardless the epinephrine concentration present in the anesthetic solution, but the Non DM presents a prolonged time for normalize their blood glucose after A100. In conclusion, this study demonstrate that epinephrine concentration (1:100.000 or 1:200.000) in articaine 4% solution have the same efficacy for periodontal surgeries. Therefore, the formulation with a lower vasoconstrictor concentration (A200) seems to be the more adequate choice for patients with systemic diseases like diabetes.