Tooth loss is considered to be a public health problem. Time-series studies that assess the influence of social conditions and access to health services on tooth loss are scarce.This study aimed to examine the time-series of permanent tooth extraction in Brazil between 1998 and 2012 and to compare these series in municipalities with different Human Development Index (HDI) scores and with different access to distinct primary and secondary care.The time-series study was performed between 1998 and 2012, using data from the Brazilian National Health Information System. Time-series study was performed between 1998 and 2012. Two annual rates of tooth extraction were calculated and evaluated separately according to 3 parameters: the HDI, the presence of a Dental Specialty Center, and coverage by Oral Health Teams. The time-series was analyzed using a linear regression model.An overall decrease in the tooth-loss tendencies during this period was observed, particularly in the tooth-extraction rate during primary care procedures. In the municipalities with an HDI that was lower than the median, the average tooth-loss rates were higher than in the municipalities with a higher HDI. The municipalities with lower rates of Oral Health Team coverage also showed lower extraction rates than the municipalities with higher coverage rates.In general, Brazil has shown a decrease in the trend to extract permanent teeth during these 15 years. Increased human development and access to dental services have influenced tooth-extraction rates.
Different periodontal surgical techniques have been proposed for the treatment of periodontal recessions. Among these, the graft of gingival connective tissue stands out for the high predictability of success. This work compared the clinical outcomes of treatment of periodontal recessions, using the gingival connective tissue grafts and acellular dermal matrix. A total of 72 recessions constituted the sample, divided equally into 2 groups. Group 1: treated with acellular dermal matrix graft (MDA) associated with the displaced: Group 2: treated with gingival connective tissue graft, also associated with the flap offset coronally. We evaluated the clinical parameters of probing depth, insert, clinical periodontal recession towards coronal-apical diameter mesio-distal of recessions, keratinized and mucosa thickness flap and influence of grafts in relation to root coverage. The initial measures were compared to those obtained with 45, 90 and 120 days after surgery. No statistically significant differences were found between the groups in terms of reduction of periodontal recessions, keratinized and mucosa flap thickness and of grafts in relation to root coverage. The Group 2 (CG) showed statistically significant reduction in the depth of drilling and clinical level of insertion, compared to group 1 (MDA). However, these differences were not clinically relevant. It was concluded that both the gingival connective tissue graft as the acellular dermal matrix can be used in the treatment of periodontal recessions, with a high predictability of success.Keywords: Gingival recession, connective tissue graft, acellular dermal matrix, periodontal surgery, gum recession, root coverage.
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