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Associação de fatores oclusais e gengivais com lesão cervical não cariosa: estudo controlado e pareado

Authors: Adriana Gonçalves da Silva;

Associação de fatores oclusais e gengivais com lesão cervical não cariosa: estudo controlado e pareado

Abstract

A lesão cervical não cariosa (LCNC) caracteriza-se por perda da estrutura dentária na junção esmalte-cemento (JCE). Foi sugerido que cargas oclusais que incidem lateralmente causam flexão das cúspides e uma grande concentração de tensão na região cervical do dente. Além disso, a recessão gengival pode estar associada com a origem da LCNC funcionando como um fator coadjuvante. A proposta deste estudo foi investigar a associação de fatores oclusais e gengivais com LCNC. Trata-se de um estudo observacional em humanos, com delineamento transversal controlado e pareado, considerando como unidade de análise um par de dentes pré-molares selecionado no mesmo indivíduo. Os pré-molares com LCNC foram designados grupo caso e pré-molares sem LCNC como grupo controle. Para selecionar o controle, elegeu-se o dente homólogo ou o dente adjacente ao pré-molar determinado como caso. As variáveis de risco estudadas foram: presença de desgaste dentário oclusal, contatos oclusais cêntricos, presença de contato durante os movimentos de lateralidade e protrusão da mandíbula, altura da mucosa ceratinizada, altura da gengiva inserida e o biotipo gengival. Considerou-se como variável desfecho a presença de LCNC. A amostra probabilística constituiu-se de 56 voluntários que atendiam aos critérios de seleção. Um examinador calibrado [Kappa= (0,89 -1,0) e Coeficiente de correlação intraclasse = 0,97] realizou a avaliação clínica para os diferentes critérios de diagnóstico. Os resultados obtidos pelo teste de McNemar, para as variáveis de risco categóricas, mostraram que não houve associação significativa entre as variáveis oclusais e o biotipo gengival com LCNC (p>0,05). O teste estatístico de Wilcoxon mostrou que o grupo caso apresentou altura de mucosa ceratinizada (p=0,046) e altura de gengiva inserida (p=0,023) significativamente menores que as do grupo controle. Concluiu-se que não houve associação entre fatores oclusais e LCNC. A altura de mucosa ceratinizada e de gengiva inserida parecem atuar como fatores coadjuvantes para a ocorrência da LCNC.

The non-carious cervical lesion (NCCL) is characterized by the loss of tooth structure at the cemento-enamel junction (CEJ). It has been suggested that lateral occlusal loads cause cusp bending and large stress concentration on the tooth cervical region. Furthermore, gingival recession may be associated with the origin of NCCL acting as a contributing factor. The purpose of this study was to investigate the factors associated to occlusal and gingival NCCL. This is an observational, cross-sectional controlled and matched study in humans, the unit of analysis being a couple of premolars selected in each individual. The premolars featuring NCCL were assigned to the case group while premolars without NCCL were part of the control group. For the control group, a counterpart tooth, or the tooth adjacent to the premolar determined as appropriate, was selected. The risk variables studied were: presence of occlusal tooth wear, centric occlusal contacts, presence of contact during lateral movement and protrusion of the mandible, height of keratinized mucosa and the gingival biotype. Presence of LCNC was taken as the outcome variable. The random sample consisted of 56 volunteers who met the selection criteria. A calibrated examiner [Kappa= (0,89 -1,0) and Intraclass correlation coefficient = 0,97] performed the clinical evaluation for the different diagnostic criteria. The results obtained using the McNemar test for categorical risk variables showed no significant association between the variables and the gingival biotype with NCCL (p>.05). The Wilcoxon statistical test showed that the case group height of keratinized mucosa (p=0.046) and height of attached gingiva (p=0.023) were significantly lower than those of the control group. Conclusion was drawn that no association existed between occlusal factors and NCCL. The height of keratinized mucosa as well of inserted gingival seem to act as collaborator factors for the NCCL occurrence.

Keywords

Mucosa bucal, Fatores de risco, Força de mordida, Oclusão dentária, Oclusão (Odontologia), Desgaste dos dentes, Força da mordida

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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