Abstract
Background and aim:
No information exists about the behavior of human gingival tissue close to composite cements used to treat crown and dental neck defects. The reaction of the human gingival to composite build up performed in the dental neck area and the coronal part of the dental root was analyzed in this study.
Methods:
Composite build up (Esthet.X®) was necessary to ensure marginal tissue stability after secure dental dam apposition. Esthet.X® was used in 14 healthy patients with almost one tooth jeopardized at the neck/root zone and requiring endodontic -conservative therapy. The perimeter of the residual coronal tooth had to present at least a subgingival section and another section consisting of natural enamel. It was requested to permit subsequent comparison of the gingival tissues close to the natural hard tissues of the tooth (control site) and to the composite restorations (test site).
Three months after the Esthet.X® build up, the crown lengthening surgical procedure was performed to restore the physiological dimension of the biological space. During the surgical procedure, the secondary flap was harvested, fastened to a semi-rigid support, fixed in buffered 4% paraformaldehyde, ethanol dehydrated and methyl methacrylate embedded. The subsequent histololgical examination was performed obtaining three micron sections from biopsies and the intensity of inflammation was evaluated by Gomori trichrome or hematoxylin-eosin stain using the following grade scale of inflammation (cells/100000 µm²) with the attribution of five ranks corresponding to several increasing degrees of histological inflammation:
1 Absence or occasional (0-3)
2 Weak (4-19)
3 Moderate (20-99)
4 High (100-499)
5 Severe (500 →)
Results:
In all biopsies, the histological analysis highlighted an uneven distribution of inflammatory cells in the corion of gingiva portions, both close to the Esthet.X® restorations and the tooth hard tissues. The inflammation grade varied from severe to weak. The statistical analysis performed using the Mann-Whitney test did not show any significant difference between the corion of gingival tissue close to the restoration and hard tissue surface.
Conclusions:
This study was designed to analyze the inflammation reaction of the superficial periodontum to aid microfilled composite cement applied close to biological tissues. So the results include chronical inflammatory response but is not able to differ immune-histo-chemically the several kind of inflammatory cell population. However, never was carried out an human study to aimed to analyze this topic. The results seem to indicate that use of this kind of composite does not so much alter greatly the gingival tissue, as the patient lifestyle or dental hygiene.
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