Inter-relação Periodontia Procedimentos Restauradores: parte 1

Summary

This video script delves into the critical relationship between periodontics and restorative dentistry, emphasizing essential concepts such as biofilm control, clinical examination, and biological space. It explains how maintaining proper gingival health before restorative procedures, avoiding deep subgingival preparations, and considering different periodontal phenotypes are crucial for long-term success. The video also highlights the importance of keeping biological distance intact to prevent inflammation and bone loss, ensuring both aesthetic and functional outcomes in restorative treatments.

Takeaways

• 😀 Restorative procedures in periodontics and dentistry must consider axial cervical shape and periodontal shapes to maintain biological compatibility with the marginal periodontium.
• 😀 A healthy and stable gingival margin is essential for successful restoration procedures, as it supports papilla formation and gum health over time.
• 😀 Biofilm accumulation, inadequate polishing, and maladaptation of restorations can lead to gum inflammation, highlighting the importance of proper hygiene and restoration techniques.
• 😀 Effective plaque control, individualized brushing techniques, and patient cooperation are key to preventing periodontal issues and ensuring the longevity of restorative treatments.
• 😀 Periodontal probing is the most reliable method to detect periodontal pockets and inflammation, and it should always precede restorative treatments.
• 😀 Oral hygiene procedures such as subgingival scraping and professional cleaning are critical for maintaining the health of periodontal tissues before restorative procedures.
• 😀 Invasive dental restorations that encroach on the biological space, such as deep preparations, can lead to inflammatory processes and bone reabsorption.
• 😀 The concept of 'biological distance' or 'supracrystalline biological dimension' refers to a critical space around the tooth that should not be violated during restorative procedures to avoid damaging periodontal tissues.
• 😀 In cases of biological space invasion, treatment options include crown lengthening surgeries or orthodontic extrusion to reestablish the proper biological distance.
• 😀 The thickness of periodontal tissue, bone thickness, and keratinized mucosa are crucial factors in determining the periodontal phenotype, which influences the success of restorative procedures.
• 😀 Understanding the histological and clinical depths of gingival tissue is vital for ensuring that subgingival restorations do not compromise the biological space and lead to gum issues.

Q & A

What is the importance of understanding axial cervical shape and periodontal shapes in restorative dentistry?

Understanding axial cervical shape and periodontal shapes is crucial in restorative dentistry because it helps in reconstructing dental contours that are biologically compatible with the marginal periodontium. This contributes to the stability of the gingival margin and papilla formation over time.

How does biofilm accumulation affect periodontal health and restorative treatments?

Biofilm accumulation is the main etiology of periodontal diseases and dental caries. When biofilm is not effectively controlled, it can lead to inflammation, gum disease, and poor tissue response around restorations, compromising the success of restorative procedures.

Why is periodontal probing an important step before restorative treatments?

Periodontal probing is important because it is the most reliable method for detecting periodontal pockets, which can indicate underlying issues such as inflammation or gum disease that need to be addressed before restorative procedures.

What is the biological distance, and why should it be maintained during restorative procedures?

Biological distance refers to the space between the tooth and the surrounding gum tissues, including the connective attachment and junctional epithelium. Maintaining this space is crucial to prevent inflammation, bone resorption, and other periodontal problems that can occur when this space is violated.

What happens when the biological space is violated during dental procedures?

When the biological space is violated, it can lead to inflammatory processes in the gums, bone resorption, and the formation of periodontal pockets. This compromises the health of the periodontal tissues and can require significant corrective treatments.

How can clinicians assess whether the biological space has been invaded during restorative procedures?

Clinicians can assess the invasion of biological space through radiographs, especially interproximal radiographs, which provide a more accurate view of the position of the alveolar crest in relation to the cervical end. Probing and careful measurement of the space also help detect potential violations.

What treatment options are available if the biological distance is compromised?

Treatment options to restore the biological distance include clinical crown lengthening, which involves a surgical procedure with or without osteotomy, and orthodontic extrusion, a procedure that reestablishes the biological distance without compromising aesthetics.

How does the periodontal phenotype influence restorative planning?

The periodontal phenotype, which includes gingival thickness, bone thickness, and the width of keratinized mucosa, influences the response to restorative treatments. Thin phenotypes are more prone to gingival recession, while thick phenotypes may mask inflammation but are still susceptible to bone loss.

Why is it important to differentiate between clinical and histological depth when planning subgingival restorations?

It is important to differentiate between clinical and histological depth because clinical depth is influenced by various factors during probing, such as probe angulation, while histological depth is a more accurate measure of the actual tissue structure and should guide restorative planning.

What role does the cervical contour of the restoration play in periodontal health?

The cervical contour of the restoration is crucial because it helps ensure that the preparation does not violate the biological space. A well-contoured restoration allows for the proper health of the marginal periodontal tissues and prevents inflammation or recession.