Biography
Biography: Mauricio Barriviera
Abstract
Describe a modern technique, non-invasive, based on tomography CBCT to measure the dimensions and analyze the relationships of various periodontal structures and dental-gingival attachments. This simple method called ST-CBCT and has wide application in various dental specialties as periodontics, implant dentistry, orthodontics, prosthodontics and restorative dentistry. Furthermore, this method will help clinicians in different specialties for interdisciplinary approach. It is important to mention that this is a quantitative and not qualitative method, because discrimination is specific macro and microscopic features of tissues can not be viewed. For example, an inflamed gingiva would have a similar appearance in the ST-CBCT acquisition as a healthy gingiva. Similarly, it is not possible to distinguish different types of soft tissue (gingival epithelium and connective tissue exhibit the same appearance in acquiring STCBCT). A clear view of both soft tissue and hard periodontal structures was not managing CBCT acquisition without retraction of soft tissue and that is our discovery and we have several cases to present with great aplicaçações and clinical outcomes. Despite the fact that several CBCT systems were recently presented one of the greatest limitations of these systems is their inability to discriminate soft tissues. We reported earlier that this limitation is particularly the CBCT system and this is due to its low contrast resolution. Some articles describe different techniques to measure gingival thicknesses and distances between the structures of the periodontium. Bone probing or transgingival drilling have been widely applied for these purposes, however, this method is uncomfortable for the patient because it is invasive and must be performed through the use of local anesthesia. In addition, it is sometimes difficult to accurately determine the position of some structures, such as the CEJ and the bone crest. Also the palatal masticatory mucosa is the main donor area of soft tissue grafts, when you need to increase the dimensions of keratinized tissue around teeth and implants, cover exposed roots, and locally increase the alveolar thickness (Wennström & Pini Prato 2003). Connective tissue grafts are also indicated for increasing root complete coverage probability when associated with advanced types of gingival recession (Cortellini et al 2009;. 2008 Cairo et al.). While the choice of thickness of the palatal mucosa are of great value to better predict the outcome of various surgical procedures, pre-surgical evaluation of the donor area of thickness is usually neglected due to lack of safe methods for this purpose. For studies that applied conventional histology in cadavers to determine the thickness of the palatal mucosa (Kydd et al. 1971), the researcher had a "general idea" of the best area for removing graft. However, each patient and each area showed variations in the amount available for removal. Invasive methods such as use of needles and periodontal probes have been described in the literature (Greenberg et al., 1976, Wolf et al. 2004). These methods present a great disadvantage because they require local anesthesia and is thus usually performed immediately prior to removal of the graft, not allowing perfect planning and preoperative procedure. A non-invasive method that applies an ultrasonic device was also described; however, this method presents a certain degree of difficulty to obtain reliable results (Müller et al. 1999), however, we reported earlier that CBCT can be applied to visualize and measure the complex soft tissue dental-gum and now to evaluate. Because of limited knowledge of individual thicknesses and regional differences of the palatal mucosa, we developed a CBCT technology-based method to constantly view and precisely the dimensions of the palatal masticatory mucosa. This simple and non-invasive technique requires a CT (CBCT) standard and materials commonly used in dental offices. I would also present a study associated with Professor Jan Lindhe on evaluation of alveolar bone thickness in anterior teeth on a survey of more than 250 patients and evaluated more than 4,500 sites. This work is of paramount importance in periodontics, implant dentistry and orthodontics. In summary, we describe a new, non-invasive and powerful method for clinical data dimensions and relationships of various periodontal and dentogengivais attachments structures. This method will definitely help clinicians in planning and executing various procedures in dentistry with increased predictability.