Enxerto gengival livre - uma análise da área doadora: Revisão de literatura

Autores

DOI:

https://doi.org/10.33448/rsd-v14i10.49470

Palavras-chave:

Enxerto gengival livre, Tecido conjuntivo, Recessão gengival, Palato, Cirurgia plástica.

Resumo

O enxerto gengival livre é um procedimento amplamente consolidado na cirurgia plástica periodontal, essencial para o ganho de qualidade, quantidade, largura e espessura da gengiva queratinizada. Sua indicação é importante tanto para a estabilidade de implantes, de tecido queratinizado para a saúde peri-implantar, quanto para a prevenção e tratamento de recessões gengivais em dentes naturais. A deficiência mucogengival em dentes pode levar a inflamação, desconforto estético, hipersensibilidade, cáries radiculares e dificuldade no controle do biofilme. Atualmente, o enxerto autógeno de tecido conjuntivo do palato é considerado o tratamento padrão-ouro devido à sua previsibilidade para cobertura radicular e benefícios para a manutenção e prognóstico em cirurgias periodontais. O conhecimento da anatomia do palato é de extrema importância para o cirurgião-dentista aplicar a técnica cirúrgica escolhida com segurança no ato da incisão respeitando áreas nobres. O objetivo deste estudo foi analisar as condições da área doadora em enxertos gengivais livres.

Referências

Aguirre-Zorzano, L., Garcia-De La Fuente, A., Estefania-Fresco, R., & Marichalar-Mendia, X. (2017). Complications of harvesting a connective tissue graft from the palate. A retrospective study and description of a new technique. Journal of Clinical and Experimental Dentistry, 0–0. https://doi.org/10.4317/jced.54337

Bhatavadekar, N. B., & Gharpure, A. S. (2018). Controlled Palatal Harvest Technique for Harvesting a Palatal Subepithelial Connective Tissue Graft.

Compendium of Continuing Education in Dentistry (Jamesburg, N.J.: 1995), 39(2), e9–e12.

Bittencourt, S., Del Peloso Ribeiro, É., Sallum, E. A., Sallum, A. W., Nociti, F. H., & Casati, M. Z. (2006). Comparative 6‐Month Clinical Study of a Semilunar Coronally Positioned Flap and Subepithelial Connective Tissue Graft for the Treatment of Gingival Recession. Journal of Periodontology, 77(2), 174–181. https://doi.org/10.1902/jop.2006.050114

Bosco, A. F., & Bosco, J. M. D. (2007). An alternative technique to the harvesting of a connective tissue graft from a thin palate: Enhanced wound healing. The International Journal of Periodontics & Restorative Dentistry, 27(2), 133–139.

Broome, W. C., & Taggart, E. J. (1976). Free Autogenous Connective Tissue Grafting: Report of Two Cases. Journal of Periodontology, 47(10), 580–585. https://doi.org/10.1902/jop.1976.47.10.580

Cairo, F., Nieri, M., & Pagliaro, U. (2014). Efficacy of periodontal plastic surgery procedures in the treatment of localized facial gingival recessions. A systematic review. Journal of Clinical Periodontology, 41(s15). https://doi.org/10.1111/jcpe.12182

Çetiner, D., Bodur, A., & Uraz, A. (2004). Expanded Mesh Connective Tissue Graft for the Treatment of Multiple Gingival Recessions. Journal of Periodontology, 75(8), 1167–1172. https://doi.org/10.1902/jop.2004.75.8.1167

Chambrone, L., Chambrone, D., Pustiglioni, F. E., Chambrone, L. A., & Lima, L. A. (2008). Can subepithelial connective tissue grafts be considered the gold standard procedure in the treatment of Miller Class I and II recession-type defects? Journal of Dentistry, 36(9), 659–671. https://doi.org/10.1016/j.jdent.2008.05.007

Consolaro, A., Rebellato Júnior, V., Consolaro, M. F. M.-O., & Carvalho Júnior, J. A. R. D. (2009). Lesões necróticas na disjunção palatina: Explicação e prevenção. Revista Dental Press de Ortodontia e Ortopedia Facial, 14(5), 20–26. https://doi.org/10.1590/S1415-54192009000500004

Del Pizzo, M., Modica, F., Bethaz, N., Priotto, P., & Romagnoli, R. (2002). The connective tissue graft: A comparative clinical evaluation of wound healing at the palatal donor site: A preliminary study. Journal of Clinical Periodontology, 29(9), 848–854. https://doi.org/10.1034/j.1600-051X.2002.290910.x

Edel, A. (1974). Clinical evaluation of free connective tissue grafts used to increase the width of keratinised gingiva. Journal of Clinical Periodontology, 1(4), 185–196. https://doi.org/10.1111/j.1600-051X.1974.tb01257.x

Farnoush, A. (1978). Techniques for the Protection and Coverage of the Donor Sites in Free Soft Tissue Grafts. Journal of Periodontology, 49(8), 403–405. https://doi.org/10.1902/jop.1978.49.8.403

Han, T. J., Takei, H. H., & Carranza, F. A. (1993). The strip gingival autograft technique. The International Journal of Periodontics & Restorative Dentistry, 13(2), 180–187.

Harris, R. J. (1992). The Connective Tissue and Partial Thickness Double Pedicle Graft: A Predictable Method of Obtaining Root Coverage. Journal of Periodontology, 63(5), 477–486. https://doi.org/10.1902/jop.1992.63.5.477

Hürzeler, M. B., & Weng, D. (1999). A single-incision technique to harvest subepithelial connective tissue grafts from the palate. The International Journal of Periodontics & Restorative Dentistry, 19(3), 279–287.

Kim, D. M., & Neiva, R. (2015). Periodontal Soft Tissue Non–Root Coverage Procedures: A Systematic Review From the AAP Regeneration Workshop. Journal of Periodontology, 86(2S). https://doi.org/10.1902/jop.2015.130684

Kumar, A., Sood, V., Masamatti, S., Triveni, M., Mehta, D., Khatri, M., & Agarwal, V. (2013). Modified single incision technique to harvest subepithelial connective tissue graft. Journal of Indian Society of Periodontology, 17(5), 676. https://doi.org/10.4103/0972-124X.119294

Langer, B., & Calagna, L. (1980). The subepithelial connective tissue graft. The Journal of Prosthetic Dentistry, 44(4), 363–367. https://doi.org/10.1016/0022- 3913(80)90090-6

Langer, B., & Calagna, L. J. (1982). The subepithelial connective tissue graft. A new approach to the enhancement of anterior cosmetics. The International Journal of Periodontics & Restorative Dentistry, 2(2), 22–33.

Langer, B., & Langer, L. (1985). Subepithelial Connective Tissue Graft Technique for Root Coverage. Journal of Periodontology, 56(12), 715–720. https://doi.org/10.1902/jop.1985.56.12.715

Liu, C.-L., & Weisgold, A. S. (2002). Connective tissue graft: A classification for incision design from the palatal site and clinical case reports. The International Journal of Periodontics & Restorative Dentistry, 22(4), 373–379.

Lorenzana, E. R., & Allen, E. P. (2000). The single-incision palatal harvest technique: A strategy for esthetics and patient comfort. The International Journal of Periodontics & Restorative Dentistry, 20(3), 297–305.

McLeod, D. E., Reyes, E., & Branch‐Mays, G. (2009). Treatment of Multiple Areas of Gingival Recession Using a Simple Harvesting Technique for Autogenous Connective Tissue Graft. Journal of Periodontology, 80(10), 1680–1687. https://doi.org/10.1902/jop.2009.090187

Midda, M. (1992). The use of lasers in periodontology. Current Opinion in Dentistry, 2, 104–108.

Moraschini, V., Luz, D., Velloso, G., & Barboza, E. dS. P. (2017). Quality assessment of systematic reviews of the significance of keratinized mucosa on implant health. International Journal of Oral and Maxillofacial Surgery, 46(6), 774–781. https://doi.org/10.1016/j.ijom.2017.02.1274

Newman, M. G. et al. (2017). Carranza periodontia clínica. Elsevier.

Pini Prato, G. P., Franceschi, D., Cortellini, P., & Chambrone, L. (2018). Long‐term evaluation (20 years) of the outcomes of subepithelial connective tissue graft plus coronally advanced flap in the treatment of maxillary single recession‐type defects. Journal of Periodontology, 89(11), 1290–1299. https://doi.org/10.1002/JPER.17-0619

Raetzke, P. B. (1985). Covering Localized Areas of Root Exposure Employing the “Envelope” Technique. Journal of Periodontology, 56(7), 397–402. https://doi.org/10.1902/jop.1985.56.7.397

Ramakrishnan, T., Kaur, M., & Aggarwal, K. (2011). Root coverage using epithelial embossed connective tissue graft. Indian Journal of Dental Research, 22(5), 726. https://doi.org/10.4103/0970-9290.93466

Reino, D. M., Novaes Jr., A. B., Grisi, M. F. D. M., Maia, L. P., & Souza, S. L. S. D. (2013). Palatal Harvesting Technique Modification for Better Control of the Connective Tissue Graft Dimensions. Brazilian Dental Journal, 24(6), 565–568. https://doi.org/10.1590/0103-6440201302343

Ribeiro, F. S., Zandim, D. L., Pontes, A. E. F., Mantovani, R. V., Sampaio, J. E. C., & Marcantonio, E. (2008). Tunnel Technique With a Surgical Maneuver to Increase the Graft Extension: Case Report With a 3‐Year Follow‐Up. Journal of Periodontology, 79(4), 753–758. https://doi.org/10.1902/jop.2008.070274

Schmitt, C. M., Matta, R. E., Moest, T., Humann, J., Gammel, L., Neukam, F. W., & Schlegel, K. A. (2016). Soft tissue volume alterations after connective tissue grafting at teeth: The subepithelial autologous connective tissue graft versus a porcine collagen matrix – a pre‐clinical volumetric analysis. Journal of Clinical Periodontology, 43(7), 609–617. https://doi.org/10.1111/jcpe.12547

Stimmelmayr, M., Allen, E. P., Gernet, W., Edelhoff, D., Beuer, F., Schlee, M., & Iglhaut, G. (2011). Treatment of gingival recession in the anterior mandible using the tunnel technique and a combination epithelialized-subepithelial connective tissue graft-a case series. The International Journal of Periodontics & Restorative Dentistry, 31(2), 165–173.

Stübinger, S., Landes, C., Seitz, O., & Sader, R. (2007). Er:YAG Laser Osteotomy for Intraoral Bone Grafting Procedures: A Case Series With a Fiber‐Optic Delivery System. Journal of Periodontology, 78(12), 2389–2394. https://doi.org/10.1902/jop.2007.070162

Tatakis, D. N., Chambrone, L., Allen, E. P., Langer, B., McGuire, M. K., Richardson, C. R., Zabalegui, I., & Zadeh, H. H. (2015). Periodontal Soft Tissue Root Coverage Procedures: A Consensus Report From the AAP Regeneration Workshop. Journal of Periodontology, 86(2S). https://doi.org/10.1902/jop.2015.140376

Thoma, D. S., Zeltner, M., Hilbe, M., Hämmerle, C. H. F., Hüsler, J., & Jung, R. E. (2016). Randomized controlled clinical study evaluating effectiveness and safety of a volume‐stable collagen matrix compared to autogenous connective tissue grafts for soft tissue augmentation at implant sites. Journal of Clinical Periodontology, 43(10), 874–885. https://doi.org/10.1111/jcpe.12588

Tonetti, M. S., Cortellini, P., Pellegrini, G., Nieri, M., Bonaccini, D., Allegri, M., Bouchard, P., Cairo, F., Conforti, G., Fourmousis, I., Graziani, F., Guerrero, A., Halben, J., Malet, J., Rasperini, G., Topoll, H., Wachtel, H., Wallkamm, B., Zabalegui, I., & Zuhr, O. (2018). Xenogenic collagen matrix or autologous connective tissue graft as adjunct to coronally advanced flaps for coverage of multiple adjacent gingival recession: Randomized trial assessing non‐inferiority in root coverage and superiority in oral health‐related quality of life. Journal of Clinical Periodontology, 45(1), 78–88. https://doi.org/10.1111/jcpe.12834

Wolf, H. F. (Org.). (2005). Periodontology (3rd rev. and expanded ed). Thieme.

Zegarra-Caceres, L., Orellano-Merluzzi, A., Muniz, F. W. M. G., De Souza, S. L. S., Faveri, M., & Meza-Mauricio, J. (2024). Xenogeneic collagen matrix vs. connective tissue graft for the treatment of multiple gingival recession: A systematic review and meta-analysis. Odontology, 112(2), 317–340. https://doi.org/10.1007/s10266-023-00863-4

Zucchelli, G., Amore, C., Sforza, N. M., Montebugnoli, L., & De Sanctis, M. (2003). Bilaminar techniques for the treatment of recession‐type defects. A comparative clinical study. Journal of Clinical Periodontology, 30(10), 862–870. https://doi.org/10.1034/j.1600-051X.2003.00397.x

Zucchelli, G., Mele, M., Stefanini, M., Mazzotti, C., Marzadori, M., Montebugnoli, L., & De Sanctis, M. (2010). Patient morbidity and root coverage outcome after subepithelial connective tissue and de‐epithelialized grafts: A comparative randomized‐controlled clinical trial. Journal of Clinical Periodontology, 37(8), 728–738. https://doi.org/10.1111/j.1600-051X.2010.01550.x

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2025-10-12

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Enxerto gengival livre - uma análise da área doadora: Revisão de literatura. Research, Society and Development, [S. l.], v. 14, n. 10, p. e70141049470, 2025. DOI: 10.33448/rsd-v14i10.49470. Disponível em: https://www.rsdjournal.org/rsd/article/view/49470. Acesso em: 9 dez. 2025.