Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-23T16:14:43Z No. of bitstreams: 5 dhelfson.pdf: 6044793 bytes, checksum: e594c51a9700816657703929a344cb6e (MD5) license_url: 52 bytes, checksum: 3d480ae6c91e310daba2020f8787d6f9 (MD5) license_text: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) license.txt: 2109 bytes, checksum: aa477231e840f304454a16eb85a9235f (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-02-10T10:56:54Z (GMT) No. of bitstreams: 5 dhelfson.pdf: 6044793 bytes, checksum: e594c51a9700816657703929a344cb6e (MD5) license_url: 52 bytes, checksum: 3d480ae6c91e310daba2020f8787d6f9 (MD5) license_text: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) license.txt: 2109 bytes, checksum: aa477231e840f304454a16eb85a9235f (MD5) / Made available in DSpace on 2015-02-10T10:56:54Z (GMT). No. of bitstreams: 5 dhelfson.pdf: 6044793 bytes, checksum: e594c51a9700816657703929a344cb6e (MD5) license_url: 52 bytes, checksum: 3d480ae6c91e310daba2020f8787d6f9 (MD5) license_text: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) license.txt: 2109 bytes, checksum: aa477231e840f304454a16eb85a9235f (MD5) Previous issue date: 2013 / A retra??o gengival ? o deslocamento apical da margem gengival em rela??o ? jun??o cemento-esmalte, levando ? exposi??o radicular. Esta condi??o cl?nica pode causar hipersensibilidade dentin?ria cervical (HSDC), comprometendo a est?tica e interferindo na qualidade de vida. O objetivo deste trabalho foi avaliar o efeito do recobrimento radicular na HSDC, est?tica e qualidade de vida de pacientes portadores de retra??es gengivais classe I e II de Miller. O objetivo secund?rio foi avaliar os fatores etiol?gicos de retra??o gengival. Vinte e dois pacientes com idade variando entre 18 a 50 anos apresentaram 25 retra??es gengivais em dentes caninos e pr?-molares superiores sens?veis. Os seguintes par?metros cl?nicos foram avaliados: largura e altura das retra??es gengivais nas faces vestibulares foram medidas com um compasso de ponta seca e aferidas com o aux?lio de um paqu?metro. Tamb?m avaliou-se a altura e espessura da gengiva queratinizada, ?ndice de placa, sangramento ? sondagem, profundidade de sondagem e n?vel de inser??o cl?nica. A HSDC foi avaliada utilizando est?mulos evaporativo (jato de ar) e t?rmico (Endo-Ice?) por 5 segundos. Para mensura??o da hipersensibilidade utilizou-se escala de avalia??o num?rica. A satisfa??o est?tica e qualidade de vida foram avaliadas pelos pacientes e pelo question?rio OHIP-14 modificado, respectivamente. A etiologia das retra??es gengivais tamb?m foi investigada atrav?s de anamnese e exame cl?nico. Todas as retra??es foram tratadas atrav?s da t?cnica cir?rgica de retalho posicionado coronalmente associado ao enxerto conjuntivo subepitelial. Os par?metros cl?nicos foram avaliados no baseline e 3 meses ap?s o tratamento. A m?dia de recobrimento radicular, ap?s 90 dias, foi de 67,90%. Completo recobrimento radicular foi alcan?ado em 44% dos dentes tratados. Foi obtido redu??o estatisticamente significativa na HSDC (p <0,001), na melhora da qualidade de vida (p <0,001), e melhora dos par?metros periodontais ap?s 3 meses. Todos pacientes ficaram satisfeitos com a est?tica alcan?ada. Houve correla??o entre qualidade de vida e est?tica. N?o houve correla??o entre a porcentagem de recobrimento radicular e HSDC estimulada por ar (p = 0,256) ou frio (p = 0,563). Houve correla??o entre a dimens?o defici?ncia f?sica do OHIP-14 e quantidade de tecido queratinizado (p = 0,010) e recobrimento radicular (p = 0,035). Conclui-se que o recobrimento radicular apresentou um efeito positivo na HSDC e qualidade de vida, com melhora dos par?metros cl?nicos periodontais. O principal fator etiol?gico identificado para a retra??o gengival foi o trauma devido ? escova??o. / Disserta??o (Mestrado) ? Programa de P?s-Gradua??o em Odontologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2013. / ABSTRACT Gingival recession is the apical displacement of the gingival margin in relation to the cement-enamel junction, leading to root exposure. This condition may cause cervical dentin hypersensitivity (CDH), compromising the esthetics and interfering with quality of life. The objective of this study was to evaluate the effect of root coverage on the CDH, aesthetics and quality of life of patients with gingival recessions class I and II Miller. The secondary aim was to investigate the etiologic factors of gingival recessions. Twenty-two patients aged 18-50 years presented 25 gingival recessions in sensitive upper canines and premolars. The following parameters were assessed: width and height of the gingival recessions were assessed with a compass needle point and measured with a caliper. It was assessed the height and thickness of keratinized gingiva, plaque index, bleeding on probing, probing depth and clinical attachment level. The CDH was assessed by evaporative (air jet) and thermal (Endo-Ice?) stimuli for 5 seconds. Dentin hypersensitivity was measured using a numerical scale. The aesthetic satisfaction and quality of life were evaluated by the patients and the OHIP-14 form, respectively. The gingival recession etiology was also investigated by anamnesis and clinical exam. All gingival defects were surgically treated by the coronally advanced flap technique combined with sub-epithelial connective tissue graft. All clinical parameters were evaluated at baseline and 3 months after treatment. The mean root coverage after 90 days was 67.90%. Complete root coverage was achieved in 44% of the treated teeth. There was a statistically significant decrease in CDH (p <0.001), improvement in quality of life (p <0.001), and improvement in periodontal parameters after 3 months. All patients were satisfied with the aesthetics achieved. There was a correlation between quality of life and aesthetics. The percentage of root coverage was not correlated with the CDH stimulated by air (p = 0.256) or cold (p = 0.563). There was a correlation between the disability dimension of OHIP-14 form and the amount of keratinized tissue (p = 0.010) and root coverage (p = 0.035). It was concluded that the root coverage had a positive effect on CDH and quality of life. The clinical periodontal parameters were improved. In addition, it was noted that the main etiologic factor identified for the gingival recession was trauma due to brushing.