Aumento de espessura gengival pré-ortodontia com uso de matriz colágena suína (mucoderm®) – relato de caso clínico

Abstract

INTRODUCTION: Analyzing gingival conditions before orthodontic movements is essential to verify that the tissues are able to receive pictures. In patients who provide orthodontic treatment and have thick gingival tissue, periodontal surgery is necessary pre-orthodontics, avoiding gingival recessions. The use of xenogenous collagen matrices as a mucosal substitute for subepithelial connective tissue grafting is a good strategy to increase gingival thickness in cases of patients with little tissue in an autogenous donor area. OBJECTIVES: To report a clinical case of a patient with a thin gingival phenotype who underwent periodontal surgery to increase gingival thickness before orthodontic movement using a swine collagen matrix Mucoderm®. METHODOLOGY: A 21-year-old patient was referred by an orthodontist to the Dental Clinic of The School of Dentistry of UniGoyazes with the need to increase gingival thickness in mandibular anterior teeth before orthodontic movement. The patient was diagnosed as having a thin gingival phenotype in anterior teeth. In addition, the palate is not very thick, making it impossible to use autologous donor tissue from the palate. The clinical protocol chosen for the treatment of the case was periodontal plastic surgery to increase gingival thickness, gain of keratinized tissue and pre-orthodontic root covering with the use of porcine collagen matrix (Mucoderm®). RESULTS: In 30 and 270 days, a significant increase in gingival thickness was noted, with a change from thin to thick gingival phenotype. In addition, there was an increase in the range of keratinized mucosa, especially in 270 days due to the keratinization process. Still, it was observed that possible gingival recessions were completely covered. Thus, it occurs that within 270 days the patient had the possibility to start orthodontic treatment. FINAL CONSIDERATIONS: A gingival thickness guarantees adequate conditions to initiate orthodontic treatments safely, and the use of xenogenic collagen matrices as mucous substitutes to autogenous grafts of subepithelial connective tissue when the cases of thin gingival phenotypes.