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STATEMENT OF PROBLEM: In a prosthetically driven treatment plan, the tomographic sagittal root position in relation to the bone housing is an important factor in the decision-making process for immediate implant placement. However, other important parameters must be considered in the bone housing of each tooth, including the alveolar ridge dimensions, the buccal and the palatal bone thickness, and the root dimensions. PURPOSE: The purpose of this clinical study was to evaluate the relationship between the sagittal root position of maxillary anterior teeth and the bone housing. MATERIALS AND METHODS: A total of 420 maxillary anterior teeth were analyzed in 70 participants. The tomographic scans were classified as sagittal root position classes I, II, III, and IV. Measurements included buccal and palatal bone thickness, alveolar ridge height, alveolar ridge width, apical bone height, root length, and root width. The Pearson correlation, ANOVA, and Tukey post hoc tests were used to determine statistically significant differences (α=0.05). RESULTS: The sagittal root position distribution was 65.2%, 9.3%, 0.7%, and 24.8% for classes I, II, III, and IV, respectively. Bone housing measurements were significantly different in relation to the 4 sagittal root position classes (P<.05), except for alveolar ridge height. Post hoc analysis showed that, in class I, buccal bone thickness and alveolar bone height were significantly low, whereas root length and palatal bone thickness were high. The higher buccal bone thickness was found in class II, and lower alveolar ridge width and palatal bone thickness in class IV. These measurements in tooth groups were also significantly different over the sagittal root position classes (P<.05). The buccal bone thickness, palatal bone thickness, and alveolar ridge width presented different levels of correlation with alveolar ridge width over the sagittal root position classes. The buccal bone thickness and palatal bone thickness were weakly correlated in class I (r=0.163) and IV (r=0.222). CONCLUSIONS: Bone housing measurements were significantly different in relation to the sagittal root position of maxillary anterior teeth.

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OBJECTIVES: To evaluate the relationship between the tomographic sagittal root position (SRP) of maxillary anterior teeth and periodontal phenotype (PP). MATERIAL AND METHODS: Seventy volunteers (420 teeth) were evaluated. Clinical and photographic exams included the evaluation of gingival phenotype (GP) by transparency of the periodontal probe, keratinized tissue width (KTW), gingival architecture, tooth shape, and papilla height (PH). Soft tissue tomographic scan (ST-CBCT) measurements included the SRP classification, GP, gingival thickness in the tissue zone (GT-TZ) and in the bone zone (GT-BZ), buccal bone thickness (BBT), and the distances from the gingival margin and from cementoenamel junction to the buccal bone crest (GM-BBC and CEJ-BBC). Kruskal-Wallis test and a linear regression analysis model were used. RESULTS: The frequency of SRP over the 420 teeth was 65.2% (class I), 9.3% (class II), 0.7% (class III), and 24.8% (class IV). Linear regression analysis showed that SRP is related to PP (p < 0.05). Significantly different measurements of PP parameters were found in SRP classes. The higher and lower GT and BBT were found in classes II and I, respectively. Class IV presented the highest KTW, PH, CEJ-BBC, and GM-BBC. Central incisors (CI) classes I and II were most frequently square-shaped, while 89% of CI Class IV were triangular-shaped. CONCLUSION: The SRP of maxillary anterior teeth is related to periodontal phenotype. CLINICAL RELEVANCE: Clinical and ST-CBCT individual analysis of PP and SRP may be helpful for an esthetic and functional treatment plan based on soft and hard tissue thickness and tooth positioning.

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Esse artigo descreve uma técnica cirúrgica simplificada para obtenção de tecido conjuntivo sub epitelial do palato como uma alternativa de enxerto em rebordos edêntulos atróficos tratados com implantes. Para esse procedimento, uma incisão única paralela à margem gengival é usada para acessar o tecido conjuntivo sub epitelial. Como o tecido epitelial não é removido com o tecido conjuntivo, a área doadora do palato pode ter uma cicatrização por primeira intenção. Através de casos clínicos, a técnica é ilustrada passo a passo, demonstrando a sua aplicabilidade clínica como objetivo de aumentar a dimensão vestíbulo/palatina de rebordo, otimizando a estética

This article describes a simplified surgical technique to harvest subepithelial connective tissue grafts from the palate like an alternative to approach atrophics ridges treated by implants. For this procedure, a single incision parallel to the gingival margin is used to acess the subepithelial connective tissue. The epithelial tissue is not removed with the connective tissue, so the donorsite can heal with primary intention. With clinical cases, the technique is illustrated step, showing the clinical applicability to increase the ridge buccal/palate dimension, improving esthetics

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