Background:Photodynamic therapy (PDT) is a method of microbial reduction which can benefit periodontal treatment in areas of difficult access, such as deep pockets and furcations. The aim of this randomized controlled clinical trial was to evaluate the effects of PDT as an adjunct to full-mouth ultrasonic debridement in the treatment of severe chronic periodontitis. Material and Methods:Twenty-two patients with at least one pocket with a probing depth (PD) of ≥7 mm and one pocket with a PD of ≥5 mm and bleeding on probing (BOP) on each side of the mouth were included, characterizing a split mouth design. The control group underwent full-mouth ultrasonic debridement and the test group received the same treatment associated with PDT. The PDT was performed on only one side of the mouth and the initial step consisted of subgingival irrigation with 0.005% methylene blue dye. Two minutes after applying the photosensitizer, the low power laser - AsGaAl (Photon Lase III - PL7336, DMC, São Carlos -São Paulo, Brazil) was applied (660 nm, 100 mW, 9 J, 90 seconds per site, 320 J/cm2, diameter tip 600 µm).The following clinical parameters were evaluated: plaque index, gingival index, BOP, gingival recession (GR), PD, and clinical attachment level (CAL). All parameters were collected before, 1, 3 and 6 months after treatment.Results:An improvement in BOP, PD and CAL was observed after treatment, in both groups, but without any difference between them. After 6 months, the PD decreased from 5.11±0.56 mm to 2.83±0.47 mm in the test group (p<0.05) and from 5.15±0.46 mm to 2.83±0.40 mm in the control group (p<0.05). The CAL changed, after 6 months, from 5.49±0.76 mm to 3.41±0.84 mm in the test group (p<0.05) and from 5.53±0.54 to 3.39±0.51 mm in the control group (p<0.05).Conclusion:Both approaches resulted in significant clinical improvements in the treatment of severe chronic periodontits, however, the PDT did not provide any additional benefit to those obtained with full-mouth ultrasonic debridement used alone.
Objetivo: Revisar a literatura e apresentar um caso tratado com uma abordagem restauradora e periodontal integrada. Descrição do caso: O tratamento de uma recessão classe III de Miller com abrasão cervical no canino superior esquerdo, a qual foi previamente restaurada com resina composta e recoberta com enxerto de tecido conjuntivo subepitelial, mostrou melhora da hipersensibilidade e estética com ausência de sinais de inflamação. Conclusão: A recessão gengival classe I e II de Miller com abrasão cervical pode ser tratada com sucesso combinando a restauração do defeito com o recobrimento radicular. Contudo, são necessários mais estudos para confirmar esses resultados.
ResumoObjetivo: Revisar a literatura e apresentar um caso tratado com uma abordagem restauradora e periodontal integrada. Descrição do caso: O tratamento de uma recessão classe III de Miller com abrasão cervical no canino superior esquerdo, a qual foi previamente restaurada com resina composta e recoberta com enxerto de tecido conjuntivo subepitelial, mostrou melhora da hipersensibilidade e estética com ausência de sinais de inflamação. Conclusão: A recessão gengival classe I e II de Miller com abrasão cervical pode ser tratada com sucesso combinando a restauração do defeito com o recobrimento radicular. Contudo, são necessários mais estudos para confirmar esses resultados.Palavras-chave: Recessão gengival. Retalho cirúrgico. Abrasão dentária. TREATMENT OF GINGIVAL RECESSION WITH CERVICAL ABRASION AbstractPurpose: To review the literature and show a case treated by an integrated restorative and periodontal approach. Case description: A treatment of a Miller Class III gingival recession associated with cervical abrasion on his maxillary left canine, which was previously restored with resin composite and covered by a subepthelial connective tissue graft showed improvement of the hypersensitivity and esthetics with no signs of gingival inflammation. Conclusions: The Miller Class I and II gingival recession with cervical abrasion can be successfully treated associating the defect restoration with the root recover. However, it's necessary more studies to support these positive results.
Purpose: To review the literature and show a case treated by an integrated restorative and periodontal approach. Case description: A treatment of a Miller Class III gingival recession associated with cervical abrasion on his maxillary left canine, which was previously restored with resin composite and covered by a subepthelial connective tissue graft showed improvement of the hypersensitivity and esthetics with no signs of gingival inflammation. Conclusions: The Miller Class I and II gingival recession with cervical abrasion can be successfully treated associating the defect restoration with the root recover. However, it’s necessary more studies to support these positive results.
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